Individual
DR. BLAKE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10455 DOUBLE R BLVD, RENO, NV 89521-8905
(775) 823-9797
Mailing address
10455 DOUBLE R BLVD, RENO, NV 89521-8905
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6270
NV
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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