| Marc W Wild Dds Inc | |
|
1104 5th Ave Huntington WV 25701-2205 | |
| (304) 523-8671 | |
| (304) 523-8674 |
| Full Name | Marc W Wild Dds Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1104 5th Ave, Huntington, West Virginia |
| Authorized Official Name and Position | Marc William Wild (PRESIDENT) |
| Authorized Official Contact | 3045238671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc W Wild Dds Inc 1104 5th Ave Huntington WV 25701-2205 Ph: (304) 523-8671 | Marc W Wild Dds Inc 1104 5th Ave Huntington WV 25701-2205 Ph: (304) 523-8671 |
| NPI Number | 1487829800 |
|---|---|
| Provider Enumeration Date | 04/26/2008 |
| Last Update Date | 04/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487829800 | NPI | - | NPPES |
| 0136461000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2466 (West Virginia) | Primary |
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