Wilson Dental Clinic, Plc | |
145 N Clark St Forest City IA 50436-1615 | |
(641) 585-5431 | |
(641) 585-5435 |
Full Name | Wilson Dental Clinic, Plc |
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Speciality | Dentist - General Practice |
Location | 145 N Clark St, Forest City, Iowa |
Authorized Official Name and Position | George Alan Wilson (DENTIST) |
Authorized Official Contact | 6415855431 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wilson Dental Clinic, Plc 145 N Clark St Forest City IA 50436-1615 Ph: (641) 585-5431 | Wilson Dental Clinic, Plc 145 N Clark St Forest City IA 50436-1615 Ph: (641) 585-5431 |
NPI Number | 1164507489 |
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Provider Enumeration Date | 10/26/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164507489 | NPI | - | NPPES |
11965 | Other | IA | BC/BS OF IA FEDERAL PROGR |
0119651 | Medicaid | IA | |
0253963 | Medicaid | IA | |
48855 | Other | IA | BC/BS OF IA FEDERAL PROGR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 5660 (Iowa) | Primary |
1223G0001X | Dentist - General Practice | 7842 (Iowa) | Secondary |