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General NPI Number Information
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NPI Number | 1376843250
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Entity Type | Individual
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Provider Name | ELIZABETH TOWNE WILSON DDS
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Gender | Female
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 13065 E 17TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2532
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Country | US
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Telephone | 303-724-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 3651 E MINERAL PL
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City | CENTENNIAL
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State | CO
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Zip | 80122-3634
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Country | US
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Telephone | 720-489-5807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8318
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License Number State | CO
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