Individual
DR. ANDREW ROBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 SHERIDAN LAKE RD, RAPID CITY, SD 57702-2407
(605) 341-3068
(605) 341-5757
Mailing address
700 SHERIDAN LAKE RD, RAPID CITY, SD 57702-2407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7705
NE
1223P0221X
Pediatric Dentistry
7705
NE
1223P0221X
Pediatric Dentistry
Primary
D1348
SD
Other
Enumeration date
06/08/2021
Last updated
08/04/2023
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