Individual
DR. DAVID G WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., LLC
Contact information
Practice address
1372 N SUSQUEHANNA TRL, SUITE 140, SELINSGROVE, PA 17870-8971
(570) 743-8119
(570) 743-2009
Mailing address
1372 N SUSQUEHANNA TRL, SUITE 140, SELINSGROVE, PA 17870-8971
(570) 743-8119
(570) 743-2009
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS019605-L
PA
Other
Enumeration date
05/24/2005
Last updated
12/23/2013
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