DR. John Russell Wilson, D.D.S.

NPI #1205048089 in Rock Springs, Wyoming

Provider Information

NPI Number
1205048089
Entity Type
Individual
Name
DR. John Russell Wilson, D.D.S.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
D.D.S.
Enumeration Date
May 4, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2441 FOOTHILL BLVD
Address 2
SUITE 1171B
State
Wyoming
ZIP Code
82901-5659
Phone
(307) 382-5902

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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