# WEST WILSON DENTAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053584953
- **Authorized official:** DR. JOSEPH S DOCTORA D.D.S., M.D. (OWNER)
- **Authorized official phone:** (615) 773-1150

## Contact information

- **Practice address:** 66 E HILL DR, SUITE B, MOUNT JULIET, TN 37122-8031
- **Practice address phone:** (615) 773-1150
- **Practice address fax:** (615) 773-1110
- **Mailing address:** 66 E HILL DR, SUITE B, MOUNT JULIET, TN 37122-8031
- **Mailing address phone:** (615) 773-1150
- **Mailing address fax:** (615) 773-1110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7268 | TN | Yes |

## Other

- **Enumeration date:** 04/11/2008
- **Last updated:** 04/11/2008