NPI 1376908293

Angela Marie Wilson, EFDA

Practitioner Dental Assistant Longview, WA

Practice location

Address: 1230 7th Ave, Longview, WA 98632-3166
Phone: (360) 575-4801
Fax: (360) 575-4807

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence D1 60250616 (WA)

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Registry record

NPI: 1376908293
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Dec 2015
Record last updated: 18 Dec 2015

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.