DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACK WILSON, DMD

Active Sole Proprietor

DR. JACK WILSON, DMD is a Dentist healthcare provider located in PHOENIX, Arizona. NPI 1316002314 is currently active in the NPPES registry. Verify at CMS.

Dentist · PHOENIX, AZ

Registration Details

NPI Number
1316002314
Provider Type
Individual
Gender
Male
NPI Issued
Dec 27, 2006 (19.633918251441 yrs)
Last Updated
Jul 8, 2007
License
D6410 (AZ)
Sole Proprietor
Yes

Practice Information

Address
12320 N 32ND ST
SUITE 1
PHOENIX, AZ, 850327154
Browse AZ providers · Browse ZIP 85032
Phone
6029921384
Fax
6029926104
Primary Specialty
Dentist
122300000X

Other Dentist Providers in PHOENIX, AZ

Name Credential NPI
DR. DARWIN N. DAVIS D.D.S. 1437156080
MOHAMED N KARAWI D.D.S 1437156106
BETH HAMANN D.D.S. 1609875020
DR. BENJAMIN MARK BERSCHLER D.M.D. 1013918135
DR. SAMANTHA CALLAHAN D.D.S. 1851383848
JOHN WILLIAM DOVGAN DDS 1124011358
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.