# DR. GREGORY L WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1447386875
- **Gender:** Man
- **Credential:** DDS MS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS3832 | TN | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 11/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0106853 | BLUE CROSS BLUE SHIELD | TN |
| 05 | — | 3226180 | — | TN |
| 01 | — | 792419 | UNITED CONCORDIA | — |