Organization
ALL ABOUT KIDS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COURTNEY L WILSON DDS (CEO/PEDIATRIC DENTIST)
(901) 759-0970
Entity
Organization
Contact information
Practice address
3285 HACKS CROSS RD, STE 101, MEMPHIS, TN 38125-8918
(901) 759-0970
Mailing address
3285 HACKS CROSS RD, STE 101, MEMPHIS, TN 38125-8918
(901) 759-0970
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8557
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440932
—
TN
Enumeration date
10/23/2008
Last updated
10/23/2008
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