Individual
WILSON E WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
116 HILLS PLZ, CHARLESTON, WV 25387-2438
(304) 414-4493
(304) 720-4813
Mailing address
301 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9552
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1787
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001470512
MS BCBS
WV
05
—
0136119000
—
WV
01
—
5462128
AETNA
WV
Enumeration date
01/23/2006
Last updated
03/19/2012
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