Individual
DR. RYAN PATRICK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 STUART XING NE, CLEVELAND, TN 37312-4065
(423) 476-4160
Mailing address
150 STUART XING NE, CLEVELAND, TN 37312-4065
(423) 476-2160
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9831
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/16/2012
Last updated
07/21/2022
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