Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEROLD C WILDE, DDS MS
ActiveJEROLD C WILDE, DDS MS is a Periodontology healthcare provider located in PASCO, Washington. NPI 1588630099 is currently active in the NPPES registry. Verify at CMS.
Periodontology · PASCO, WA
Registration Details
- NPI Number
- 1588630099
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 24, 2006 (20.433718589104 yrs)
- Last Updated
- Nov 9, 2011
- License
-
DE00009195 (WA)
Practice Information
- Address
-
515 W COURT STPASCO, WA, 993013737Browse WA providers · Browse ZIP 99301
- Phone
- 5095472204
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.