RANDAL WILSON, DMD

Dentist

Active Individual
NPI: 1063846459

Practice Address

1309 BENNETT AVE
Burley, ID 83318

Phone: (208) 677-5198

Specialties

Specialty Code Primary License
Dentist 122300000X Yes D-4526 (ID)

Frequently Asked Questions

NPI 1063846459 is the National Provider Identifier for RANDAL WILSON, DMD, a Dentist provider located in Burley, ID. This NPI was enumerated on August 21, 2013.
RANDAL WILSON, DMD practices at 1309 BENNETT AVE, Burley, ID 83318.

Quick Facts

NPI
1063846459
Type
Individual
Enumerated
Aug 21, 2013
Last Updated
Mar 17, 2021

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