Individual
ASHLEY ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1079 SPACE CENTER DR UNIT 100, COLORADO SPRINGS, CO 80915-3612
(719) 596-3481
Mailing address
7558 FOREST VALLEY LOOP, COLORADO SPRINGS, CO 80908-5647
(757) 351-9180
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.002024806
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH.002024806
DORA - DENTAL HYGIENE LICENSE.
CO
Enumeration date
04/14/2018
Last updated
04/14/2018
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