PHILLIP DUANE WILSON

PORTLAND, ME
NPI1215144910
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: ME  DEN4754)
Additional Taxonomies122300000X Dentist
(Licence: TX  16752)
Enumeration Date2007-05-16
Last Update Date2020-02-10
Business Address
PHILLIP DUANE WILSON D.D.S.
716 STEVENS AVE
PORTLAND, ME 04103-2693
Phone number: 207-283-0171
Mailing Address
PHILLIP DUANE WILSON D.D.S.
716 STEVENS AVE
PORTLAND, ME 04103-2693
Phone number:
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