Organization
CHARLES L. WILSON, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LAWRENCE WILSON DDS (PRESIDENT)
(440) 442-5990
Entity
Organization
Contact information
Practice address
5231 MAYFIELD RD, LYNDHURST, OH 44124-2477
(440) 442-5990
(440) 442-9114
Mailing address
5231 MAYFIELD RD, LYNDHURST, OH 44124-2477
(440) 442-5990
(440) 442-9114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16812
OH
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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