Individual
DR. ANN L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
671 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984-5141
(772) 878-8426
Mailing address
671 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984-5141
(772) 878-8426
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8020
FL
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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