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Individual

DR. VALARIE D. WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
3155 ROYAL DR STE 125, ALPHARETTA, GA 30022-2477
(404) 612-1867
Mailing address
565 OLD FRIAR TUCK LN, STONE MOUNTAIN, GA 30087-5236
(404) 786-4207

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN011475
GA
1223G0001X
General Practice Dentistry
Primary
DN011475
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN011475
GEORGIA BOARD OF DENTISTRY
GA
Enumeration date
06/18/2020
Last updated
01/17/2023
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