| Wilson Orthodontics | |
|
1372 N Susquehanna Trl Ste 140 Selinsgrove PA 17870-8973 | |
| (570) 743-8119 | |
| (570) 743-2009 |
| Full Name | Wilson Orthodontics |
|---|---|
| Speciality | Dentist |
| Location | 1372 N Susquehanna Trl Ste 140, Selinsgrove, Pennsylvania |
| Authorized Official Name and Position | David G Wilson (OWNER/ORTHODONTIST) |
| Authorized Official Contact | 5708508119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Orthodontics 1372 N Susquehanna Trl Ste 140 Selinsgrove PA 17870-8973 Ph: (570) 743-8119 | Wilson Orthodontics 1372 N Susquehanna Trl Ste 140 Selinsgrove PA 17870-8973 Ph: (570) 743-8119 |
| NPI Number | 1154773489 |
|---|---|
| Provider Enumeration Date | 07/11/2016 |
| Last Update Date | 10/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154773489 | NPI | - | NPPES |
| 7556450001 | Other | PA | MEDICARE DME PTAN NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS019605L (Pennsylvania) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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