Individual
DR. DEXTER E. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
918 DECATHLON DR, WATERLOO, IA 50701-3441
(319) 236-2020
Mailing address
918 DECATHLON DR, WATERLOO, IA 50701-3441
(319) 236-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1657
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6146811
—
IA
Enumeration date
09/07/2005
Last updated
03/13/2008
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