Wilson Professional Dental Corporation
NPI #1497312888 in San Juan Capistrano, California
Provider Information
- NPI Number
- 1497312888
- Entity Type
- Organization
- Organization Name
- Wilson Professional Dental Corporation
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- May 22, 2019
- Last Updated
- May 22, 2019
Practice Location
- Address
- 31103 RANCHO VIEJO RD STE D5
- State
- California
- ZIP Code
- 92675-1759
- Phone
- (949) 661-3380
Authorized Official
- Name
- DR. MANDI LYNN WILSON, DDS
- Title
- DENTIST
- Phone
- (903) 330-4661
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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