Individual
DR. GREGORY BLAKE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS.MS
Contact information
Practice address
858 WYCLIFFE DR, HOUSTON, TX 77079-3512
(713) 468-1513
(281) 213-2756
Mailing address
858 WYCLIFFE DR, HOUSTON, TX 77079-3512
(713) 468-1513
(281) 213-2756
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17832
TX
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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