| NPI | 1154773489 |
|---|---|
| Doing Business As | WILSON ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | DAVID G WILSON Owner/Orthodontist 570-850-8119 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS019605L) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-10-20 |