Wilson, Spencer Grant
Wilson, Spencer Grant is an sole proprietor health care provider with primary practice located at 1355 S Higley Rd 106, Gilbert AZ 85296-4799. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Wilson, Spencer Grant can be contacted via phone (480) 279-5949.Contact Information
Primary practice address
1355 S Higley Rd 106
Gilbert AZ 85296-4799
Phone: (480) 279-5949
Fax: (480) 279-0784
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D0020739 | Texas |
Profile Details
| NPI number | 1386676922 |
|---|---|
| LBN Legal business name | Wilson, Spencer Grant |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Jul 13th, 2007 - about 17 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 | 1386676922 | NPPES |
| Arizona | MEDICAID | 502262 |
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