| John D Wildgen Dds Pc | |
|
128 S Main Street Laurie MO 65038-1083 | |
| (573) 374-5739 | |
| (573) 374-8901 |
| Full Name | John D Wildgen Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 128 S Main Street, Laurie, Missouri |
| Authorized Official Name and Position | John D Wildgen (PRESIDENT) |
| Authorized Official Contact | 5733745739 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Wildgen Dds Pc Po Box 1083 Laurie MO 65038-1083 Ph: (573) 374-5739 | John D Wildgen Dds Pc 128 S Main Street Laurie MO 65038-1083 Ph: (573) 374-5739 |
| NPI Number | 1831208594 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 12/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831208594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0133788 (Missouri) | Primary |