Individual
DR. ROLAND D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 E MAIN ST, MT HOREB, WI 53572
(608) 437-8666
(608) 437-3605
Mailing address
215 E MAIN ST, MT HOREB, WI 53572
(608) 437-8666
(608) 437-3605
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3827WI
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33499400
—
WI
Enumeration date
10/04/2006
Last updated
07/08/2007
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