Individual
DR. MICHAEL JEREMY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
2900 CROASDAILE DR, SUITE 3, DURHAM, NC 27705-2579
(919) 383-7423
(919) 383-3444
Mailing address
2900 CROASDAILE DR, SUITE 3, DURHAM, NC 27705-2579
(919) 383-7423
(919) 383-3444
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7088
NC
Other
Enumeration date
04/30/2007
Last updated
07/08/2007
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