Wilde, John A
Wilde, John A is an individual health care provider with primary practice located at 1626 Morgan St Suite 3, Keokuk IA 52632. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wilde, John A can be contacted via phone (319) 524-1477.Contact Information
Primary practice address
1626 Morgan St Suite 3
Keokuk IA 52632
Phone: (319) 524-1477
Fax: (319) 524-7965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 05824 | Iowa |
Profile Details
| NPI number | 1265501316 |
|---|---|
| LBN Legal business name | Wilde, John A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1265501316 | NPPES |
| Iowa | Other | 05824 | IA DENTAL LICENSE |
| Iowa | MEDICAID | 1089326 | IA DENTAL LICENSE |
| Iowa | Other | 38071 | IA DENTAL LICENSE |
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