Doretha M Wilson Valid NPI
Individual provider · Dental Hygienist · Winterhaven, CA
- NPI
- 1407554686
- Type
- Individual (Type 1)
- Primary specialty
- Dental Hygienist
- Specialty group
- Dental Providers
- Taxonomy code
- 124Q00000X
- License number
- 3209 (KY)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2023-02-17
- Last updated
- 2023-02-17
Practice location
401 Picacho Rd
Winterhaven, CA 92283-9605
(760) 572-4811