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Individual

DR. JODY RENEE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
11711 N PENNSYLVANIA ST, SUITE 114, CARMEL, IN 46032-6959
(317) 816-0841
Mailing address
3532 SOARING EAGLE CT, INDIANAPOLIS, IN 46214-1468
(317) 551-8040

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012331A
IN

Other

Enumeration date
06/30/2015
Last updated
03/27/2017
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