# DANIEL E. WILSON, DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CASCADE DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669973160
- **Authorized official:** DR. DANIEL EDWIN WILSON DMD (PRESIDENT/OWNER)
- **Authorized official phone:** (360) 314-8723

## Contact information

- **Practice address:** 16703 SE MCGILLIVRAY BLVD STE 100, VANCOUVER, WA 98683-3418
- **Practice address phone:** (360) 892-2994
- **Practice address fax:** (360) 892-3929
- **Mailing address:** 16703 SE MCGILLIVRAY BLVD STE 100, VANCOUVER, WA 98683-3418
- **Mailing address phone:** (360) 892-2994
- **Mailing address fax:** (360) 892-3929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D7955 | OR | — |
| 1223G0001X | General Practice Dentistry | DE00009284 | WA | Yes |

## Other

- **Enumeration date:** 02/21/2018
- **Last updated:** 02/21/2018