Individual
DR. WILLIAM ROY WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12711 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6053
(360) 896-4484
Mailing address
PO BOX 385, TROUT LAKE, WA 98650-0385
(509) 395-2002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00009016
WA
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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