Individual
DR. SEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7537 N CLARK ST, CHICAGO, IL 60626-1621
(202) 412-2824
Mailing address
2720 W 23RD ST, UNIT 2, CHICAGO, IL 60608
(202) 412-2824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034975
IL
122300000X
Dentist
7501
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/10/2023
Last updated
08/05/2024
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