Individual
BARRY STUART WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
805 MIDDLE COUNTRY RD, SELDEN, NY 11784-2504
(631) 732-0233
(631) 732-0247
Mailing address
805 MIDDLE COUNTRY RD, SELDEN, NY 11784-2504
(631) 732-0233
(631) 732-0247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
030059
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065Z759
—
NY
Enumeration date
11/02/2005
Last updated
04/01/2008
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