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Organization
JOHN WILSON DDS, PLLC
Active
Organization
JOHN WILSON DDS, PLLC
Active
Other names
Pine Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILSON (OWNER)
(208) 263-8535
Entity
Organization
Contact information
Practice address
2005 PINE ST, SANDPOINT, ID 83864-9327
(509) 949-8147
Mailing address
2005 PINE ST, SANDPOINT, ID 83864-9327
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4649
ID
Other
Enumeration date
06/26/2015
Last updated
09/19/2025
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