# KRISTINA N WILSON DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730937830
- **Authorized official:** DR. KRISTINA WILSON DMD (OWNER/DENTIST)
- **Authorized official phone:** (623) 293-6765

## Contact information

- **Practice address:** 18275 N 59TH AVE STE 150, GLENDALE, AZ 85308-1253
- **Practice address phone:** (602) 942-0623
- **Mailing address:** 18275 N 59TH AVE STE 150, GLENDALE, AZ 85308-1253
- **Mailing address phone:** (602) 942-0623
- **Mailing address fax:** (602) 942-2409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2024
- **Last updated:** 08/18/2026