| Wilson Dental, Pc | |
|
610 S Salina St Syracuse NY 13202-3524 | |
| (607) 238-1280 | |
| (607) 238-1286 |
| Full Name | Wilson Dental, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 610 S Salina St, Syracuse, New York |
| Authorized Official Name and Position | Michael P Wilson (PRESIDENT/OWNER) |
| Authorized Official Contact | 6072381280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Dental, Pc 610 S Salina St Syracuse NY 13202-3524 Ph: (607) 238-1280 | Wilson Dental, Pc 610 S Salina St Syracuse NY 13202-3524 Ph: (607) 238-1280 |
| NPI Number | 1457661316 |
|---|---|
| Provider Enumeration Date | 10/13/2010 |
| Last Update Date | 10/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457661316 | NPI | - | NPPES |
| 02950874 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50-052924 (New York) | Primary |
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