Individual
DR. CAROL A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
100 LAKE ST, NICHOLASVILLE, KY 40356-1002
(859) 885-5703
(859) 885-5703
Mailing address
104 KENTON CT, NICHOLASVILLE, KY 40356-9096
(859) 492-2735
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8377
KY
1223G0001X
General Practice Dentistry
8377
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100094910
—
KY
Enumeration date
02/27/2007
Last updated
01/26/2012
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