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Contact Information

DAN R WILSON, DDS
813 1/2 COLUMBIA STREET
813 1/2 COLUMBIA #99
POMEROY, WA99347
 Phone: 509-834-3495
 Fax: 509-843-3496
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DAN R WILSON · (Male)

NPI Number 1346351525
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 08/31/2006
Last updated 03/06/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ID License # D1862
  • WA License # 5974
  • WA Medicaid 2074241
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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