Individual
DR. ROBERT CARL WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
201 N WASHINGTON ST, NEWBERG, OR 97132-2727
(503) 538-2560
Mailing address
14800 SW BULL MOUNTAIN RD, TIGARD, OR 97224-1233
(503) 590-1480
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5798
OR
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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