Individual
DR. DONALD LEWIS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
7250 REDWOOD BLVD STE 107, NOVATO, CA 94945-3269
(415) 878-0240
(415) 878-0242
Mailing address
7250 REDWOOD BLVD STE 107, NOVATO, CA 94945-3269
(415) 878-0240
(415) 878-0242
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
47822
CA
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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