Individual
DR. RYNE PATRICK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8603 FOREST HILLS BLVD, DALLAS, TX 75218-4024
(432) 352-1305
Mailing address
8603 FOREST HILLS BLVD, DALLAS, TX 75218-4024
(432) 352-1305
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
31333
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350348402
—
TX
Enumeration date
08/13/2015
Last updated
06/16/2022
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