Dan R Wilson, DDS
Dentist, General Practice in Pomeroy, WA. Individual provider (NPI-1).
NPI number1346351525
StatusActive
Last updated in NPPESMar 6, 2019
Details
- NPI
- 1346351525
- Entity type
- Individual (NPI-1)
- Name
- Mr. Dan R Wilson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Mar 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D1862 | ID | Yes |
| 1223G0001X | Dentist, General Practice | 5974 | WA |
Practice location
813 1/2 Columbia Street813 1/2 Columbia #99
Pomeroy, WA 99347
Phone 509-834-3495 · Fax 509-843-3496
Mailing address
Po Box 99Pomeroy, WA 99347-0099
Phone 509-843-3495 · Fax 509-843-3496
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.