Wade Wilson
NPI #1629639018 in Valparaiso, Indiana
Provider Information
- NPI Number
- 1629639018
- Entity Type
- Individual
- Name
- Wade Wilson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Enumeration Date
- Jun 26, 2019
- Last Updated
- Jun 26, 2019
Practice Location
- Address
- 334 W US HIGHWAY 30 STE G
- City
- Valparaiso
- State
- Indiana
- ZIP Code
- 46385-5395
- Phone
- (219) 464-9887
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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