Individual
SHEILA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
3434 E WASHINGTON AVE, MADISON, WI 53704-4155
(608) 443-5482
(608) 443-5553
Mailing address
3434 E WASHINGTON AVE, MADISON, WI 53704-4155
(608) 443-5482
(608) 443-5553
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3420-016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3420-016
STATE LICENSE
WI
Enumeration date
12/19/2006
Last updated
07/08/2007
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