Individual
COREY MICHAEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1011 FOREST HILL BLVD., SUITE 331, WELLINGTON, FL 33414
(561) 798-0825
Mailing address
6929 ASHTON ST, BOYNTON BEACH, FL 33437-6044
(561) 703-1783
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN16632
FL
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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