Individual
DR. BRIAN ROBERT WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
1320 W INA RD, TUCSON, AZ 85704-3115
(520) 742-1232
(520) 742-0925
Mailing address
1320 W INA RD, TUCSON, AZ 85704-3115
(575) 522-1779
(520) 742-1232
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D010529
AZ
Other
Enumeration date
07/15/2013
Last updated
06/08/2020
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