Female

Dr. Latonya Waller DDS

General Practice Dentistry in Detroit, MI(View on Map)

Full Name

Dr. Latonya Waller DDS

NPI Number

1265841977

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/06/2014

Specialties

(Taxonomies)

Code

1223G0001X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

2901021345

Contact
Information

Purpose

Mailing
Location

Address

76 W ADAMS AVE APT 1604
4727 SAINT ANTOINE ST

City

Detroit
Detroit

State

MI
MI

Postal Code

48226-1667
48201-1461

Country

US
US

Telephone Number

N/A
(313) 833-7309

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/06/2014

Provider Address

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