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Spencer K. Wilde, DDS
Dentist Anesthesiologist in Mesa, Arizona
NPI 1295893196

Spencer K. Wilde is a Dentist Anesthesiologist based in Tucson, AZ and is specialized in Dentist Anesthesiologist. Spencer K. Wilde practices in Mesa, AZ and has the professional credentials of DDS. The NPI Number for Spencer K. Wilde is 1295893196 and holds a License No. D5497 (Arizona).

The current practice location address for Spencer K. Wilde is 625 W Southern Ave Ste E-145, Mesa, AZ and can be reached out via phone at 480-710-8081 and via fax at 866-814-1886.

Location: 625 W Southern Ave Ste E-145, Mesa, AZ, 85750-0739
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Provider Profile Details
NPI Number
1295893196
Provider Name
Spencer K. Wilde
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
625 W Southern Ave Ste E-145, Mesa, AZ, 85750-0739
Phone Number
480-710-8081
Fax Number
866-814-1886
Provider Enumeration Date
12/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
884644 01 AZ AHCCCS PROVIDER ID DSDA
863573 01 AZ AHCCCS PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
625 W Southern Ave Ste E-145
City
State
Zip
85210-5030
Phone Number
480-710-8081
Fax Number
866-814-1886
person
Provider Business Mailing Address Details
Address
625 W Southern Ave Ste E-145
City
State
Zip
85210-5030
Phone Number
480-710-8081
Fax Number
866-814-1886
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
License No.
D5497 (Arizona)
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
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