Gregg A Wilson, DDS

NPI #1164516225 in Boise, Idaho

Provider Information

NPI Number
1164516225
Entity Type
Individual
Name
Gregg A Wilson, DDS
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist
Credential
DDS
Enumeration Date
Oct 3, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
10497 GARVERDALE COURT
Address 2
SUITE 107
City
Boise
State
Idaho
ZIP Code
83704
Phone
(208) 375-5720

Specialties & Taxonomy Codes

Specialty
Dentist

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