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DR. WAYNE WILSON

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1235260498

Individual Registrant:
DR. WAYNE  WILSON 
Gender: M
Sole Proprietor

Location and contact information for practice:
977 E ST.  WILLIAMS, CA 95987-0099 US
Tel: 530-473-2882  Fax: 530-473-5477

Contact information for business:
PO BOX 99 977 E STREET WILLIAMS, CA 95987-0099 US
Tel: 530-473-2882  Fax: 530-473-5477

Registration Information:
NPI: 1235260498
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CA22121

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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