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Individual

DR. BRADEN WILDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MSD

Contact information

Practice address
1400 S FOOTHILL DR STE 240, SALT LAKE CITY, UT 84108-2300
(801) 581-1234
Mailing address
1282 E QUAIL GROVE CIR, MURRAY, UT 84121-6562
(385) 539-1055

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D-4592
ID
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6258159-9922
UT

Other

Enumeration date
06/27/2014
Last updated
06/15/2023
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