Individual
IRVIN LARRY WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9015 #1 LIBERTY RD., RANDALLSTOWN, MD 21133
(410) 922-6800
(410) 922-6801
Mailing address
9015 #1 LIBERTY RD., RANDALLSTOWN, MD 21133
(410) 922-6800
(410) 922-6801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5877
MD
Other
Enumeration date
06/04/2007
Last updated
10/16/2019
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