Individual
DR. LAURA WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
409 DUNLAP ST N, SAINT PAUL, MN 55104-4201
(651) 290-9200
Mailing address
409 DUNLAP ST N, SAINT PAUL, MN 55104-4201
(651) 290-9200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13419
MN
Other
Enumeration date
06/15/2014
Last updated
06/15/2014
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