| Desy P Wilson Dds Ms Pc | |
|
859 Ne 7th St Grants Pass OR 97526-1634 | |
| (541) 474-0860 | |
| Not Available |
| Full Name | Desy P Wilson Dds Ms Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 859 Ne 7th St, Grants Pass, Oregon |
| Authorized Official Name and Position | Desy Wilson (PRESIDENT) |
| Authorized Official Contact | 5414740860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desy P Wilson Dds Ms Pc 2073 Sw Park Ave Apt 221 Portland OR 97201-3121 Ph: () - | Desy P Wilson Dds Ms Pc 859 Ne 7th St Grants Pass OR 97526-1634 Ph: (541) 474-0860 |
| NPI Number | 1588007264 |
|---|---|
| Provider Enumeration Date | 04/11/2013 |
| Last Update Date | 04/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588007264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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