Individual
DR. JARELL LAMONZ WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
D010564
AZ
1223G0001X
General Practice Dentistry
059461
NY
1223P0221X
Pediatric Dentistry
Primary
D010564
AZ
1223P0221X
Pediatric Dentistry
DN31327
FL
390200000X
Student in an Organized Health Care Education/Training Program
D010564
AZ
Other
Enumeration date
08/22/2016
Last updated
06/12/2026
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