DR. Richard Lyman Wilson, DDS

NPI #1104042761 in Ignacio, Colorado

Provider Information

NPI Number: 1104042761
Entity Type: Individual
Name: DR. Richard Lyman Wilson, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Apr 18, 2007
Last Updated: Oct 10, 2014

Practice Location

Address: 123 WEEMINUCHE AVE
City: Ignacio
State: Colorado
ZIP Code: 81137
Phone: (970) 563-4581

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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