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Individual
DR. SARAH A WILSON
Active
Individual
DR. SARAH A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008962
IN
122300000X
Dentist
54001011A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12008962
—
IN
Enumeration date
11/06/2006
Last updated
05/11/2017
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