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Individual

DR. DAVID EARL WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
3335 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 524-3770
Mailing address
2145 ELKHORN DR, EUGENE, OR 97408-1204
(541) 653-9188
(541) 345-8037

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D8541
OR

Other

Enumeration date
05/07/2007
Last updated
11/12/2007
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