Individual
DR. KATHRYN LEIGH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
175 BEACH 121ST ST, ROCKAWAY PARK, NY 11694-1960
(607) 368-5396
Mailing address
593 MERRICK ROAD, LYNBROOK, NY 11563
(516) 561-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
055474
NY
Other
Enumeration date
07/06/2011
Last updated
12/14/2015
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