Individual
ANGELA MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4801
(360) 575-4807
Mailing address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4801
(360) 575-4807
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D1 60250616
WA
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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