Individual
KRISTINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
18275 N 59TH AVE STE 150, GLENDALE, AZ 85308-1253
(602) 942-0623
Mailing address
5527 W ANDREA DR, PHOENIX, AZ 85083-6361
(623) 293-6765
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009508
AZ
Other
Enumeration date
06/23/2016
Last updated
05/13/2024
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