Individual
LAUREN KIRSTEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
410 E 61ST ST N, PARK CITY, KS 67219-1906
(316) 744-0001
Mailing address
410 E 61ST ST N, PARK CITY, KS 67219-1906
(316) 744-0001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
62123
KS
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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