Individual
ADRIAN S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
901 S 15TH ST, LOUISVILLE, KY 40210-1368
(800) 787-2812
Mailing address
901 S 15TH ST, LOUISVILLE, KY 40210-1368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10548
KY
1223G0001X
General Practice Dentistry
30.026684
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/07/2020
Last updated
03/19/2025
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