Individual
MICHELE WILDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2725 AFFIRMED DRIVE, JANESVILLE, WI 53546-4416
(608) 931-6119
Mailing address
2725 AFFIRMED DR, JANESVILLE, WI 53546-4416
(608) 931-6119
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
9737-16
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9737-16
REGISTERED DENTAL HYGIENIST
WI
Enumeration date
08/07/2017
Last updated
07/21/2022
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