David M. Wilson
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
3801 Glenkerry Ct Ste 2
Portage
, Michigan 49024-0711
David M. Wilson
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
3801 Glenkerry Ct Ste 2
Portage
, Michigan 49024-0711
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- David M. Wilson
- 3801 Glenkerry Ct Ste 2
- Portage, MI
- Zip : 49024-0711
- Phone :
Second Address
- David M. Wilson
- 3801 Glenkerry Ct Ste 2
- Portage, MI
- Zip : 49024-0711
- Phone : (269) 323-1527
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2901019878 | MI |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 4301100207 | MI |
National Provider Identifier
| NPI | 1376705038 |
|---|---|
| Provider Name | David M. Wilson |
| First Address | Portage, MI 49024-0711 |
| Second Address | Portage, MI 49024-0711 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2008 |
| Last Update Date | 20/10/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.