Individual
DR. CHARLYN A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7685 WOLF RIVER CIR, SUITE 102, GERMANTOWN, TN 38138-1749
(901) 751-1100
(901) 751-1164
Mailing address
7685 WOLF RIVER CIR, SUITE 102, GERMANTOWN, TN 38138-1749
(901) 751-1100
(901) 751-1164
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS7079
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4132991
BLUE CROSS BLUE SHIELD
TN
Enumeration date
02/22/2007
Last updated
07/08/2007
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