Individual
DR. ANGELA S WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1245 E SOUTHERN AVE STE 12, MESA, AZ 85204-5138
(480) 636-9970
Mailing address
5354 E HARMONY AVE, MESA, AZ 85206-5506
(760) 920-5501
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009821
AZ
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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