Individual
DR. SHELLEY ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2460 LAKESHORE DR, SAINT JOSEPH, MI 49085-1874
(269) 983-5583
(269) 983-5663
Mailing address
2520 S STATE ST, SAINT JOSEPH, MI 49085-1935
(269) 983-7683
(269) 983-5663
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901017656
MI
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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