MEDICARE: DR. SPENCER GRANT WILSON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	D0020739	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386676922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SPENCER GRANT WILSON D.D.S.

Provider Business Mailing Address
First Line	:	1355 S HIGLEY RD
Second Line	:	106
City	:	GILBERT
State	:	AZ
Zip	:	85296-4799
Country	:	US
Telephone Number	:	480-279-5949
Fax Number	:	480-279-0784

Provider Business Practice Location Address
First Line	:	1355 S HIGLEY RD
Second Line	:	106
City	:	GILBERT
State	:	AZ
Zip	:	85296-4799
Country	:	US
Telephone Number	:	480-279-5949
Fax Number	:	480-279-0784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/13/2007

Similar Medicare Providers

1063377364 — DR. ELIZABETH GUADALUPE ALANNA PT, DPT
Practice Location Address:

1355 S HIGLEY RD STE 101
GILBERT, AZ
85296-4799

Practice Phone: 480-507-8080
Practice Fax:

1124076005 — STEVEN EARL SPRINGBORN PT
Practice Location Address:

1355 S HIGLEY RD , SUITE 101
GILBERT, AZ
85296-4799

Practice Phone: 480-507-8080
Practice Fax: 480-507-8085

1255369849 — MOLLIE CALLANAN PT
Practice Location Address:

1355 S HIGLEY RD STE 101
GILBERT, AZ
85296-4799

Practice Phone: 480-507-8080
Practice Fax:

1518088210 — JULIET SHARLEY M.S. OTR/L CHT
Practice Location Address:

1355 S HIGLEY RD STE 101
GILBERT, AZ
85296-4799

Practice Phone: 480-507-8080
Practice Fax: 480-507-8085

1801094875 — SIENNA SPRINGS DENTAL PLLC
Practice Location Address:

1355 S HIGLEY RD , 120
GILBERT, AZ
85296-4799

Practice Phone: 480-279-5233
Practice Fax: 480-840-6808

1205011095 — DR. BRENT TYLER ROBISON DMD, MS, MSD
Practice Location Address:

1355 S HIGLEY RD STE 105
GILBERT, AZ
85296-4799

Practice Phone: 480-888-7711
Practice Fax:

Directions to “ DR. SPENCER GRANT WILSON D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.