Individual
JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
246 BILLINGS RD, HERMON, ME 04401-0535
(207) 848-3384
Mailing address
25 LIBERTY AVE, HAMPDEN, ME 04444-1345
(207) 249-8730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN5025
ME
1223G0001X
General Practice Dentistry
DN22425
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2016
Last updated
12/02/2024
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