# MARC W WILD DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487829800
- **Authorized official:** DR. MARC WILLIAM WILD DDS (PRESIDENT)
- **Authorized official phone:** (304) 523-8671

## Contact information

- **Practice address:** 1104 5TH AVE, HUNTINGTON, WV 25701-2205
- **Practice address phone:** (304) 523-8671
- **Practice address fax:** (304) 523-8674
- **Mailing address:** 1104 5TH AVE, HUNTINGTON, WV 25701-2205
- **Mailing address phone:** (304) 523-8671
- **Mailing address fax:** (304) 523-8674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 2466 | WV | Yes |

## Other

- **Enumeration date:** 04/26/2008
- **Last updated:** 04/26/2008