Individual
JAMIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION927 TRETTEL LANE, CLOQUET, MN 55720
(218) 879-1227
(218) 878-3755
Mailing address
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION927 TRETTEL LANE, CLOQUET, MN 55720
(218) 879-1227
(218) 878-3755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12812
MN
Other
Enumeration date
07/14/2010
Last updated
04/10/2012
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