| Kent W Wilson Dds Inc | |
|
1941 Huntington Drive Suite B South Pasadena CA 91030 | |
| (626) 441-1167 | |
| Not Available |
| Full Name | Kent W Wilson Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1941 Huntington Drive, South Pasadena, California |
| Authorized Official Name and Position | Kent W Wilson (PRESIDENT) |
| Authorized Official Contact | 6264411167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent W Wilson Dds Inc 1941 Huntington Drive Suite B South Pasadena CA 91030 Ph: (626) 441-1167 | Kent W Wilson Dds Inc 1941 Huntington Drive Suite B South Pasadena CA 91030 Ph: (626) 441-1167 |
| NPI Number | 1790864254 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790864254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25654 (California) | Primary |
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