Individual
JANICE MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD RN
Contact information
Practice address
360 NEW ALBANY PLZ, NEW ALBANY, IN 47150-4654
(812) 618-9346
Mailing address
PO BOX 11568, OVERLAND PARK, KS 66207-4268
(913) 428-1670
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
KY7035
KY
1223G0001X
General Practice Dentistry
Primary
12013054A
IN
Other
Enumeration date
10/25/2006
Last updated
10/11/2018
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