Individual
DR. JARELL LAMONZ WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
NAVAJO SERVICE RTE 41, PINON, AZ 86510
(928) 725-9500
Mailing address
PO BOX 681, PINON, AZ 86510-0681
(843) 593-5905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059461
NY
390200000X
Student in an Organized Health Care Education/Training Program
D010564
AZ
Other
Enumeration date
08/22/2016
Last updated
02/25/2020
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