Individual
ANDREW DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2301 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4427
(215) 282-8000
Mailing address
1010 ARCH ST UNIT 513, PHILADELPHIA, PA 19107-3021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041330
PA
1223P0221X
Pediatric Dentistry
22DR03097
NJ
Other
Enumeration date
06/05/2017
Last updated
12/22/2017
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