| Wild Family Dentistry Pllc | |
|
750 Main St Ste 215 Mendota Heights MN 55118-3768 | |
| (651) 452-0261 | |
| (651) 452-6109 |
| Full Name | Wild Family Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 750 Main St Ste 215, Mendota Heights, Minnesota |
| Authorized Official Name and Position | Laura Elizabeth Wild (PRESIDENT) |
| Authorized Official Contact | 6123274582 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Family Dentistry Pllc 750 Main St Ste 215 Mendota Heights MN 55118-3768 Ph: (651) 452-0261 | Wild Family Dentistry Pllc 750 Main St Ste 215 Mendota Heights MN 55118-3768 Ph: (651) 452-0261 |
| NPI Number | 1598458655 |
|---|---|
| Provider Enumeration Date | 06/02/2023 |
| Last Update Date | 06/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598458655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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