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Organization

LAMPLIGHTER DENTAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELGIN WADE WILDE DMD (DENTIST)
(406) 294-2900
Entity
Organization

Contact information

Practice address
2675 CENTRAL AVE, SUITE 13, BILLINGS, MT 59102-6686
(406) 294-2900
Mailing address
2675 CENTRAL AVE, SUITE 13, BILLINGS, MT 59102-6686
(406) 294-2900

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2218
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113607
MT
Enumeration date
05/20/2009
Last updated
05/20/2009
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