Organization
THOMAS K WILSON DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS K WILSON DMD (PROPRIETOR)
(785) 827-9325
Entity
Organization
Contact information
Practice address
520 S SANTA FE AVE, 240, SALINA, KS 67401-4190
(785) 827-9325
(785) 827-6252
Mailing address
520 S SANTA FE AVE, 240, SALINA, KS 67401-4190
(785) 827-9325
(785) 827-6252
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5719
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008775
MEDICARE PTAN
KS
Enumeration date
11/19/2012
Last updated
12/26/2012
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