Individual
DR. FRED H WILSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1395 SATTLER RD STE 4, CANYON LAKE, TX 78132-2296
(830) 964-3161
(830) 226-5019
Mailing address
PO BOX 2225, 1395 SATTLER RD #4, CANYON LAKE, TX 78133-0009
(830) 964-3161
(830) 226-5019
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14592
TX
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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