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Organization
KENT W WILSON DDS INC
Active
Organization
KENT W WILSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT W WILSON DDS (PRESIDENT)
(626) 441-1167
Entity
Organization
Contact information
Practice address
1941 HUNTINGTON DRIVE, SUITE B, SOUTH PASADENA, CA 91030
(626) 441-1167
Mailing address
1941 HUNTINGTON DRIVE, SUITE B, SOUTH PASADENA, CA 91030
(626) 441-1167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25654
CA
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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