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General NPI Number Information
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NPI Number | 1851024202
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Entity Type | Individual
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Provider Name | LAUREN YOUNG WILSTON DMD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 725 SKIPPACK PIKE STE 125
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City | BLUE BELL
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State | PA
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Zip | 19422-1704
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Country | US
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Telephone | 215-641-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CARMEL PL
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City | NEWTOWN
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State | PA
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Zip | 18940-1730
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Country | US
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Telephone |
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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 | DS044425
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02916200
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License Number State | NJ
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