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Individual

DR. JAMES KENNETH WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
121 S ESTES DRIVE, SUITE 205C, CHAPEL HILL, NC 27516
(919) 928-0105
(919) 928-0630
Mailing address
10404 MANLY, CHAPEL HILL, NC 27517
(919) 933-1646
(919) 933-3739

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4157
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7999405
NC
Enumeration date
11/13/2006
Last updated
07/08/2007
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