DR. MONTY C. WILSON D.D.S. NPI 1487726055

NPI Information

DR. Monty C. Wilson, D.D.S. is an oral and maxillofacial surgery dentist in Orange, CA with 31 years of experience. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Monty C. Wilson, D.D.S. NPI is 1487726055. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY
Graduation Year:1993

The provider's business location address is:

1122 E LINCOLN AVE
STE. 105
ORANGE, CA
ZIP 92865-907
Phone: (714) 998-7450
Fax: (714) 998-2857

The NPI 1487726055 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/15/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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