| C. Todd Wilson D.d.s.p.c. | |
|
17680 Sw Handley Street Suite 202 Sherwood OR 97140-8795 | |
| (503) 925-1566 | |
| (503) 925-1576 |
| Full Name | C. Todd Wilson D.d.s.p.c. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 17680 Sw Handley Street, Sherwood, Oregon |
| Authorized Official Name and Position | Dava J. Wilson (OFFICE MANAGER) |
| Authorized Official Contact | 5039251566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Todd Wilson D.d.s.p.c. 17680 Sw Handley Street Suite 202 Sherwood OR 97140-8795 Ph: (503) 925-1566 | C. Todd Wilson D.d.s.p.c. 17680 Sw Handley Street Suite 202 Sherwood OR 97140-8795 Ph: (503) 925-1566 |
| NPI Number | 1316164056 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 01/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316164056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D7723 (Oregon) | Primary |
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