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Organization
GREGGORY S. WILDE, DDS, PS
Active
Organization
GREGGORY S. WILDE, DDS, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGGORY WAYNE SCOTT WILDE DDS (PRESIDENT)
(360) 692-0300
Entity
Organization
Contact information
Practice address
3594 NW LOWELL ST, SILVERDALE, WA 98383-9116
(360) 692-0300
(360) 698-2988
Mailing address
PO BOX 1970, SILVERDALE, WA 98383-1970
(360) 692-0300
(360) 698-2988
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE00004274
WA
Other
Enumeration date
10/12/2006
Last updated
08/22/2020
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