Individual
ALLISON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5861 MASON-DIXON HIGHWAY, BOX 72, BLACKSVILLE, WV 26521
(304) 432-8211
(304) 432-8213
Mailing address
5861 MASON-DIXON HIGHWAY, BOX 72, BLACKSVILLE, WV 26521
(304) 432-8211
(304) 432-8213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3565
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4005183000
—
WV
Enumeration date
04/21/2006
Last updated
02/28/2008
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