Organization
MARC W WILD DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC WILLIAM WILD DDS (PRESIDENT)
(304) 523-8671
Entity
Organization
Contact information
Practice address
1104 5TH AVE, HUNTINGTON, WV 25701-2205
(304) 523-8671
(304) 523-8674
Mailing address
1104 5TH AVE, HUNTINGTON, WV 25701-2205
(304) 523-8671
(304) 523-8674
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2466
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136461000
—
WV
Enumeration date
04/26/2008
Last updated
04/26/2008
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