Individual
KIMBERLY D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4941 OLIVEHURST AVE, OLIVEHURST, CA 95961-4225
(530) 743-4614
Mailing address
935 MARKET ST, YUBA CITY, CA 95991-4217
(916) 292-2377
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
24554
CA
Other
Enumeration date
07/13/2017
Last updated
09/17/2020
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