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Organization
DR. SCOTT WILSON DDS PLLC 4
Active
Organization
DR. SCOTT WILSON DDS PLLC 4
Active
Other names
Luminous Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT WILSON (OWNER)
(725) 291-5588
Entity
Organization
Contact information
Practice address
1212 S MARYLAND PKWY, LAS VEGAS, NV 89104-1728
(725) 291-5588
Mailing address
1212 S MARYLAND PKWY, LAS VEGAS, NV 89104-1728
(725) 291-5588
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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