| Richard L Wilson Dds | |
|
102 Half 18th St Durango CO 81301 | |
| (970) 247-5565 | |
| (970) 247-8988 |
| Full Name | Richard L Wilson Dds |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 102 Half 18th St, Durango, Colorado |
| Authorized Official Name and Position | Richard Lyman Wilson (DENTIST) |
| Authorized Official Contact | 9702475565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard L Wilson Dds 102 Half 18th St Durango CO 81301 Ph: (970) 247-5565 | Richard L Wilson Dds 102 Half 18th St Durango CO 81301 Ph: (970) 247-5565 |
| NPI Number | 1669548319 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669548319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7355 (Colorado) | Primary |
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