Individual
DR. KATIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
388 W. TERRA COTTA AVE., CRYSTAL LAKE, IL 60014
(608) 361-0311
Mailing address
388 W. TERRA COTTA AVE., CRYSTAL LAKE, IL 60014
(608) 361-0311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032869
IL
Other
Enumeration date
06/15/2017
Last updated
07/31/2023
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