Individual
DR. SANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
29 BLACK COAL DRIVE, FORT WASHAKIE, WY 82514
(307) 332-7300
Mailing address
100 CHEYENNE AVENUE, LAME DEER, MT 59043-0070
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5561
OK
Other
Enumeration date
05/21/2007
Last updated
06/08/2018
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