Individual
JOHN WESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1095 SE BISHOP BLVD, PULLMAN, WA 99163-5452
(509) 715-1700
(509) 715-1030
Mailing address
1095 SE BISHOP BLVD, PULLMAN, WA 99163-5452
(509) 715-1700
(509) 715-1030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60233391
WA
1223G0001X
General Practice Dentistry
DE60233391
WA
Other
Enumeration date
06/20/2011
Last updated
03/26/2021
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