Individual
DR. JAMES GORDON WILSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1810 S MACDILL AVE, TAMPA, FL 33629-5960
(813) 251-0770
(813) 251-0771
Mailing address
1810 S MACDILL AVE, TAMPA, FL 33629-5960
(813) 251-0770
(813) 251-0771
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN0013537
FL
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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