Individual
DR. JUSTIN RICHARD WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11800 SINGLETREE LN, EDEN PRAIRIE, MN 55344-5328
(952) 237-8619
Mailing address
9651 WYOMING TER S, BLOOMINGTON, MN 55438-1606
(952) 237-8619
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D13192
MN
Other
Enumeration date
04/15/2011
Last updated
12/23/2025
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