Organization
GREGGORY S. WILDE, DDS, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGGORY WAYNE SCOTT WILDE DDS (PRESIDENT)
(360) 692-0300
Entity
Organization
Contact information
Practice address
3594 NW LOWELL ST, SILVERDALE, WA 98383-9116
(360) 692-0300
(360) 698-2988
Mailing address
PO BOX 1970, SILVERDALE, WA 98383-1970
(360) 692-0300
(360) 698-2988
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE00004274
WA
Other
Enumeration date
10/12/2006
Last updated
08/22/2020
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