Provider Demographics
NPI:1336283456
Name:WILLIAM M. WILDEN, DDS, P.C.
Entity Type:Organization
Organization Name:WILLIAM M. WILDEN, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-928-6800
Mailing Address - Street 1:8901 E TRENT AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2333
Mailing Address - Country:US
Mailing Address - Phone:509-928-6800
Mailing Address - Fax:
Practice Address - Street 1:8901 E TRENT AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2333
Practice Address - Country:US
Practice Address - Phone:509-928-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty