Organization
SHANNON WILSON DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON WILSON DDS (OWNER)
(206) 920-5430
Entity
Organization
Contact information
Practice address
11730 15TH AVE NE, SEATTLE, WA 98125-5026
(206) 920-5430
Mailing address
18529 LINDEN AVE N, SHORELINE, WA 98133-3926
(206) 920-5430
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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