Individual
DR. CHARLES L WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
225 SHERIDAN DR, CAPE GIRARDEAU, MO 63703-5939
(573) 334-7159
Mailing address
225 SHERIDAN DR, CAPE GIRARDEAU, MO 63703-5939
(573) 334-7159
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MO11676
MO
Other
Enumeration date
06/23/2005
Last updated
07/08/2007
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