Randal Wilson, DMD
NPI 1063846459 · on the registry since 2013
Practice
- Address
- 1309 Bennett Ave
Burley, ID 83318 - Phone
- (208) 677-5198
- Organisation at this address
- Family Health Services Corporation
Family Health Services CorporationInferred from a shared address, not stated in the registry. - Clinicians at this address
- 16
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-03-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho