Individual
JOANIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
208 PARKWAY BLVD, ELIZABETHTON, TN 37643-2845
(423) 543-5200
(423) 543-1499
Mailing address
103 STARLIGHT DR, ELIZABETHTON, TN 37643-6145
(423) 213-7789
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5089
TN
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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