Individual
DR. CASEY S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1931 N 8TH ST, SHEBOYGAN, WI 53081-2740
(920) 783-6633
(920) 783-6635
Mailing address
1931 N 8TH ST, SHEBOYGAN, WI 53081-2740
(920) 783-6633
(920) 783-6635
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7244-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
05/19/2014
Last updated
05/28/2014
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