Latonya Waller, DDS

NPI 1265841977 · on the registry since 2014 · sole proprietor

Practice

Address: 4727 Saint Antoine St
Detroit, MI 48201
Phone: (313) 833-7309
Organisation at this address: S Madani Md Pc
Global Health Ipa
Hemalata Reddy Md
Brent W Gillum D O Plc
Jackson Health Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 26

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2014-08-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan