Organization
LOREN G. WILSON D.D.S. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOREN WILSON D.D.S. (PRESIDENT)
(618) 273-9684
Entity
Organization
Contact information
Practice address
1030 4TH ST, ELDORADO, IL 62930-1702
(618) 273-9684
(618) 273-7107
Mailing address
670 BIXLER RD, ELDORADO, IL 62930-3786
(618) 273-9684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
02/09/2007
Last updated
08/22/2020
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