Individual
DR. RICHARD LYMAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
123 WEEMINUCHE AVE, IGNACIO, CO 81137
(970) 563-4581
(970) 563-4581
Mailing address
PO BOX 737, SUHC, IGNACIO, CO 81137-0737
(970) 563-4581
(970) 563-4581
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
CO7355
CO
Other
Enumeration date
04/18/2007
Last updated
10/10/2014
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