Individual
DR. CAROLYN FERN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MSD
Contact information
Practice address
3219 MACARTHUR, # 100, IRVING, TX 75062
(972) 252-7569
(972) 258-0502
Mailing address
6121 KENWOOD DRIVE, DALLAS, TX 75149
(214) 502-1204
(214) 828-8132
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
11548
TX
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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