Individual
DR. LAWRENCE ERNEST WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1231 N TUTTLE AVE, SARASOTA, FL 34237-3116
(941) 366-0134
(866) 622-3009
Mailing address
4440 FRUITVILLE RD, SARASOTA, FL 34232-1926
(941) 366-0134
(941) 404-1760
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13270
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075192800
—
FL
Enumeration date
02/06/2007
Last updated
06/24/2019
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