Individual
DAVID LEE WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
41253 12TH ST W, SUITE C, PALMDALE, CA 93551-1413
(661) 266-8840
Mailing address
41253 12TH ST W, SUITE C, PALMDALE, CA 93551-1413
(661) 266-8840
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D25778
CA
Other
Enumeration date
09/20/2005
Last updated
07/08/2007
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