Individual
DR. TRAVIS W. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1042 N MAIN ST, BEAVER DAM, KY 42320-1553
(270) 274-3645
(270) 274-3452
Mailing address
1042 N MAIN ST, BEAVER DAM, KY 42320-1553
(270) 274-3645
(270) 274-3452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7199
KY
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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