Organization
SPENCER G WILSON DDS PC
Active
Organization
SPENCER G WILSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER G WILSON D.D.S (PRESIDENT)
(480) 279-5949
Entity
Organization
Contact information
Practice address
1355 S HIGLEY RD STE 106, GILBERT, AZ 85296-4799
(480) 279-5949
(480) 279-0784
Mailing address
1355 S HIGLEY RD STE 106, GILBERT, AZ 85296-4799
(480) 279-5949
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D0020739
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502262
—
AZ
Enumeration date
01/09/2008
Last updated
01/09/2008
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