Individual
STEVEN LAMAR WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4059 COLUMBIA RD, MARTINEZ, GA 30907-2221
(706) 863-9445
(706) 863-7452
Mailing address
4059 COLUMBIA RD, MARTINEZ, GA 30907-2221
(706) 863-9445
(706) 863-7452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064424A
—
GA
Enumeration date
03/27/2006
Last updated
03/02/2020
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