Individual
DR. RYAN SCOTT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3706 DAVIS STUART RD, LEWISBURG, WV 24901-9463
(304) 645-6124
Mailing address
3706 DAVIS STUART RD, LEWISBURG, WV 24901-9463
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4210
WV
Other
Enumeration date
05/22/2016
Last updated
05/22/2016
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