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Individual

LILIAN WAGAS REED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
671 DOVE DR, PERRIS, CA 92570-1955
(909) 255-5670
Mailing address
30035 HAUN RD, MENIFEE, CA 92584-6805
(951) 566-9090

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA92660
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RDA92660
CA
Enumeration date
04/18/2019
Last updated
04/18/2019
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