| Wild Child Orthodontics | |
|
17677 Cedar Ave Lakeville MN 55044-2250 | |
| (952) 903-9484 | |
| (952) 941-7091 |
| Full Name | Wild Child Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17677 Cedar Ave, Lakeville, Minnesota |
| Authorized Official Name and Position | Justin Wild (DOCTOR) |
| Authorized Official Contact | 9529039484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Child Orthodontics 11800 Singletree Ln Ste 200 Eden Prairie MN 55344-5397 Ph: (952) 903-9484 | Wild Child Orthodontics 17677 Cedar Ave Lakeville MN 55044-2250 Ph: (952) 903-9484 |
| NPI Number | 1972296481 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 05/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972296481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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