Ryan H Wilson DDS LLC

NPI #1942604533 in Farmington, New Mexico

Provider Information

NPI Number: 1942604533
Entity Type: Organization
Organization Name: Ryan H Wilson DDS LLC
Primary Specialty: Dentist
Enumeration Date: Oct 10, 2014
Last Updated: Oct 10, 2014

Practice Location

Address: 4760 N BUTLER AVE STE D
City: Farmington
State: New Mexico
ZIP Code: 87401-0816
Phone: (505) 278-7007

Authorized Official

Name: DR. RYAN HASTIIN WILSON, D.D.S.
Title: PRESIDENT/OWNER DENTIST
Phone: (505) 278-7007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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