| NPI | 1407914674 |
|---|---|
| Doing Business As | WILDER SENIOR DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CRAIG BINGER Vice President Administration 651-642-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |