Individual
DR. SHAN CHRISTOPHER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
321 S 2ND ST, HOUSTON, MO 65483-1424
(417) 967-4528
Mailing address
321 S 2ND ST, HOUSTON, MO 65483-1424
(417) 967-4528
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011014268
MO
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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