Organization
PAUL R WILD DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WILLIAM WILD DDS (OWNER)
(651) 452-0261
Entity
Organization
Contact information
Practice address
750 MAIN ST, SUITE 215, MENDOTA HEIGHTS, MN 55118
(651) 452-0261
(651) 452-6109
Mailing address
750 MAIN ST, SUITE 215, MENDOTA HEIGHTS, MN 55118
(651) 452-0261
(651) 452-6109
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
11/07/2019
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