Organization
KRISTINA L. WILEY, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTINA L. WILEY D.D.S. (CEO/ OWNER)
(707) 678-9248
Entity
Organization
Contact information
Practice address
140 N JACKSON ST, SUITE 1, DIXON, CA 95620-3034
(707) 678-9248
(707) 678-9274
Mailing address
140 N JACKSON ST, SUITE 1, DIXON, CA 95620-3034
(707) 678-9248
(707) 678-9274
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41149
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9337301
—
CA
Enumeration date
10/28/2010
Last updated
10/28/2010
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