Richard David Wildman, DMD

NPI #1003999749 in Mccall, Idaho

Provider Information

NPI Number: 1003999749
Entity Type: Individual
Name: Richard David Wildman, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 210 PARK STREET
Address 2: RICHARD D WILDMAN
City: Mccall
State: Idaho
ZIP Code: 83638-2249
Phone: (208) 634-7071

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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