Individual
DR. CHRISTOPHER MCLEAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
55 CENTRAL STREET, RANDOLPH, VT 05060
(802) 728-3343
(802) 276-3538
Mailing address
P.O. BOX 416, RANDOLPH, VT 05060
(802) 728-3343
(802) 276-3538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16-0001184
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003924
—
VT
Enumeration date
10/12/2006
Last updated
11/11/2020
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