Organization
MARION N WILSON JR., DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KERMA JO WILSON (OFFICE MANAGER)
(615) 847-3088
Entity
Organization
Contact information
Practice address
102 22ND ST, OLD HICKORY, TN 37138-2502
(615) 847-3088
(615) 847-8479
Mailing address
PO BOX 511, OLD HICKORY, TN 37138-0511
(615) 847-3088
(615) 847-8479
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4168
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518374271
NPI
TN
01
—
1588674519
NPI
TN
Enumeration date
10/17/2014
Last updated
10/17/2014
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