Individual
BRIANNE L. WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10472 ROOSEVELT BLVD N, ST PETERSBURG, FL 33716-3820
(727) 399-6938
Mailing address
10472 ROOSEVELT BLVD N, ST PETERSBURG, FL 33716-3820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 22089
FL
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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