Individual
KALEI NGUYEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1300 E CITY ROUTE 40, GREENVILLE, IL 62246-2501
(618) 664-1483
Mailing address
355 CROWN PT, COLUMBIA, MO 65203-2202
(573) 356-1149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022749
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2022
Last updated
06/15/2022
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