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Individual

MARK E WILSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4526 15TH AVE NE, SEATTLE, WA 98105-4507
(206) 523-8094
(206) 522-4634
Mailing address
4526 15TH AVE NE, SEATTLE, WA 98105-4507
(206) 523-8094
(206) 522-4634

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006240
WA

Other

Enumeration date
06/08/2006
Last updated
07/08/2007
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