Individual
DR. NATHAN PAUL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
108 FAIRFIELD DR, NICHOLASVILLE, KY 40356-8842
(859) 881-8632
(859) 881-0522
Mailing address
108 FAIRFIELD DR, NICHOLASVILLE, KY 40356-8842
(859) 881-8632
(859) 881-0522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8091
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8091
STATE LICENSE NUMBER
KY
Enumeration date
05/10/2007
Last updated
07/08/2007
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