Individual
PAYDEN TY WILDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
885 VALLEY CREST DR, CARSON CITY, NV 89705-6881
(435) 764-3924
Mailing address
885 VALLEY CREST DR, CARSON CITY, NV 89705-6881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6800
NV
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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