NPI 1043500648
Justin Richard Wild, DDS
Practice location
- Address
- 11800 Singletree Ln, Eden Prairie, MN 55344-5328
- Phone
- (952) 237-8619
- Mailing address
- 9651 Wyoming Ter S, Bloomington, MN 55438-1606
Registered specialties
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
Registry record
- NPI
- 1043500648
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 15 Apr 2011
- Record last updated
- 23 Dec 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.