Organization
JOHN WILSON DDS, PLLC
Active
Other names
Pine Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILSON (OWNER)
(208) 263-8535
Entity
Organization
Contact information
Practice address
2005 PINE ST, SANDPOINT, ID 83864-9327
(509) 949-8147
Mailing address
2005 PINE ST, SANDPOINT, ID 83864-9327
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4649
ID
Other
Enumeration date
06/26/2015
Last updated
09/19/2025
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