| Wilson Dental Clinic, Plc | |
|
145 N Clark St Forest City IA 50436-1615 | |
| (641) 585-5431 | |
| (641) 585-5435 |
| Full Name | Wilson Dental Clinic, Plc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 145 N Clark St, Forest City, Iowa |
| Authorized Official Name and Position | George Alan Wilson (DENTIST) |
| Authorized Official Contact | 6415855431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Dental Clinic, Plc 145 N Clark St Forest City IA 50436-1615 Ph: (641) 585-5431 | Wilson Dental Clinic, Plc 145 N Clark St Forest City IA 50436-1615 Ph: (641) 585-5431 |
| NPI Number | 1164507489 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164507489 | NPI | - | NPPES |
| 11965 | Other | IA | BC/BS OF IA FEDERAL PROGR |
| 0119651 | Medicaid | IA | |
| 0253963 | Medicaid | IA | |
| 48855 | Other | IA | BC/BS OF IA FEDERAL PROGR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7842 (Iowa) | Secondary |
| 1223G0001X | Dentist - General Practice | 5660 (Iowa) | Primary |