Organization
WILD FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA ELIZABETH WILD DDS (PRESIDENT)
(612) 327-4582
Entity
Organization
Contact information
Practice address
750 MAIN ST STE 215, MENDOTA HEIGHTS, MN 55118-3768
(651) 452-0261
(651) 452-6109
Mailing address
750 MAIN ST STE 215, MENDOTA HEIGHTS, MN 55118-3768
(651) 452-0261
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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