Individual
MR. JAMES L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
207 W FRONT ST, LIBERTY, SC 29657-1009
(864) 843-3742
(864) 843-3744
Mailing address
207 W FRONT ST, LIBERTY, SC 29657-1009
(864) 843-3742
(864) 843-3744
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3144
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z31449
—
SC
Enumeration date
04/26/2006
Last updated
07/09/2007
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