| Dr Sandra Wilson, DDS | |
|
29 Black Coal Drive, Fort Washakie, WY 82514 | |
| (307) 332-7300 | |
| Not Available |
| Full Name | Dr Sandra Wilson |
|---|---|
| Gender | Female |
| Speciality | Dentist |
| Location | 29 Black Coal Drive, Fort Washakie, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235348962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5561 (Oklahoma) | Primary |
| Entity Name | U S Health Dept of Health & Human Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972694602 PECOS PAC ID: 9638081623 Enrollment ID: O20031106000399 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sandra Wilson, DDS 100 Cheyenne Avenue, Lame Deer, MT 59043-0070 Ph: Not Available | Dr Sandra Wilson, DDS 29 Black Coal Drive, Fort Washakie, WY 82514 Ph: (307) 332-7300 |
Andrew Foster Huff, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 29 Black Coal Dr, Fort Washakie, WY 82514 Phone: 307-332-7300 Fax: 307-332-3949 |
Dr. Kevin Michael Sheridan, DDS Dentist Medicare: Medicare Enrolled Practice Location: 29 Black Coal Dr, Fort Washakie, WY 82514 Phone: 307-332-7300 |
Dr. Jason Adam Jurca, DDS Dentist Medicare: May Accept Medicare Assignments Practice Location: 29 Black Coal Drive, Fort Washakie, WY 82514 Phone: 307-332-7300 |