Provider Demographics
NPI:1891176541
Name:WILDUNG, AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:WILDUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 E SHEA BLVD
Mailing Address - Street 2:#101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6180
Mailing Address - Country:US
Mailing Address - Phone:480-991-3244
Mailing Address - Fax:
Practice Address - Street 1:6920 E SHEA BLVD
Practice Address - Street 2:#101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6180
Practice Address - Country:US
Practice Address - Phone:480-991-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0092441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice