Individual
DR. RICHARD SMITH WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2401 PENNSYLVANIA AVE, SUITE 1A8, PHILADELPHIA, PA 19130-3010
(215) 765-5281
(215) 765-7334
Mailing address
2401 PENNSYLVANIA AVE, SUITE 1A8, PHILADELPHIA, PA 19130-3010
(215) 765-5281
(215) 765-7334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS025826L
PA
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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