NPI 1023347945

John Gordon Wilson, LD

Practitioner Denturist Baker City, OR

Practice location

Address: 715 Nicole Way, Baker City, OR 97814-6183
Phone: (541) 523-8529

Registered specialties

Denturist Primary

Dental Providers Taxonomy 122400000X Licence DTDO10126518 (OR)

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Registry record

NPI: 1023347945
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Dec 2009
Record last updated: 2 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.