Individual
MATTHEW WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
54 TAYLOR RD SE # 9281, OWENS CROSS ROADS, AL 35763-9498
(256) 536-0418
Mailing address
8420 HOGAN DR SE, HUNTSVILLE, AL 35802-3432
(256) 655-4766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-0007065-C1
AL
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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