Organization
LEONARD B WILSON DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD BEVER WILSON DMD (OWNER)
(541) 672-2747
Entity
Organization
Contact information
Practice address
1333 W HARVARD AVE, ROSEBURG, OR 97471-2838
(541) 672-2747
(866) 216-6527
Mailing address
1333 W HARVARD AVE, ROSEBURG, OR 97471-2838
(541) 672-2747
(866) 216-6527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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