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Individual
DR. SEAN WILSON
Active
Individual
DR. SEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034975
IL
122300000X
Dentist
7501
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/10/2023
Last updated
08/05/2024
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