Individual
MARK I WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5280 N UNIVERSITY DR, LAUDERHILL, FL 33351-5018
(954) 749-4594
(954) 578-9575
Mailing address
5280 N UNIVERSITY DR, LAUDERHILL, FL 33351-5018
(954) 749-4594
(954) 578-9575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN9814
FL
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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