Wild, Marc William
Wild, Marc William is an sole proprietor health care provider with primary practice located at 1104 5Th Ave , Huntington WV 25701-2205. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wild, Marc William can be contacted via phone (304) 523-8671.Contact Information
Primary practice address
1104 5Th Ave
Huntington WV 25701-2205
Phone: (304) 523-8671
Fax: (304) 523-8674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2466 | West Virginia |
Profile Details
| NPI number | 1912916180 |
|---|---|
| LBN Legal business name | Wild, Marc William |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912916180 | NPPES |
| West Virginia | MEDICAID | 0136461000 |
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