Organization
C. TODD WILSON D.D.S.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAVA J. WILSON (OFFICE MANAGER)
(503) 925-1566
Entity
Organization
Contact information
Practice address
17680 SW HANDLEY STREET, SUITE 202, SHERWOOD, OR 97140-8795
(503) 925-1566
(503) 925-1576
Mailing address
17680 SW HANDLEY STREET, SUITE 202, SHERWOOD, OR 97140-8795
(503) 925-1566
(503) 925-1576
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D7723
OR
Other
Enumeration date
04/20/2007
Last updated
01/24/2012
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