Individual
DR. LOREN JAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2331 MASSACHUSETTS AVENUE, CAMBRIDGE, MA 02140
(617) 876-8636
(617) 661-4894
Mailing address
10 KELLY ROAD, CAMBRIDGE, MA 02139
(617) 803-0887
(617) 661-4894
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14418
MA
Other
Enumeration date
07/27/2006
Last updated
09/30/2015
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