Wilson, Douglas W
Wilson, Douglas W is an individual health care provider with primary practice located at 100 River Place Suite 110, Madison WI 53716. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Wilson, Douglas W can be contacted via phone (608) 222-6160.Contact Information
Primary practice address
100 River Place Suite 110
Madison WI 53716
Phone: (608) 222-6160
Fax: (608) 222-6248
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 1695G | Wisconsin |
Profile Details
| NPI number | 1164533345 |
|---|---|
| LBN Legal business name | Wilson, Douglas W |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164533345 | NPPES |
| Wisconsin | MEDICAID | 33376600 |
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