NPI 1104959519 · live from the CMS NPI Registry
Douglass Charles Wilson, D.M.D
Dentist, Orthodontics and Dentofacial Orthopedics in Keene, NH. National Provider Identifier 1104959519, active.
NPI record
| NPI | 1104959519 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 69 Island St Ste Q, Keene, NH 03431 |
| Practice phone | 603-352-0255 |
| Enumerated | March 14, 2007 |
| Last updated | January 20, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 3428 (NH) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | 016-0002204 (VT) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | 22063 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.