Individual
DR. DWIGHT CLARENCE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1117 S MAIN ST, HARTFORD, KY 42347-1835
(270) 298-7923
(270) 298-7286
Mailing address
1740 14TH ST, BEAVER DAM, KY 42320-8966
(270) 274-5076
(270) 298-7286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5784
KY
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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