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Individual

DR. RASHIDAH TYNETTA WILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
2400 MARITIME DR, ELK GROVE, CA 95758-3660
(916) 686-8914
Mailing address
9700 W TARON DR, ELK GROVE, CA 95757-8145
(916) 378-1007

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
10225
KY
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
64355
CA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DEN4597
ME

Other

Enumeration date
04/10/2012
Last updated
01/16/2024
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