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Individual

KELLYE WATKINS WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
420 S. CHARLES SEIVERS BLVD, CLINTON, TN 37716
(865) 457-1496
Mailing address
2750 DUTCH VALLEY RD, CLINTON, TN 37716-5406
(865) 254-4563

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00002692
TN

Other

Enumeration date
12/16/2018
Last updated
12/16/2018
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