NPI | 1477636280 |
---|---|
Former Legal Business Name | SHAWN K WILSON DDS |
Entity Type | Organization |
Authorized Contact | SHAWN KEVIN WILSON Owner Operator 530-222-0515 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 032518) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2014-10-02 |