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Organization

WEST WILSON DENTAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH S DOCTORA D.D.S., M.D. (OWNER)
(615) 773-1150
Entity
Organization

Contact information

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

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3226329
TN
Enumeration date
04/11/2008
Last updated
04/11/2008
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