NPI 1164154498

Matthew Wilson, DMD

Practitioner Dentist Owens Cross Roads, AL

Practice location

Address: 54 Taylor Rd SE # 9281, Owens Cross Roads, AL 35763-9498
Phone: (256) 536-0418
Mailing address: 8420 Hogan Dr SE, Huntsville, AL 35802-3432

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D-0007065-C1 (AL)

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Registry record

NPI: 1164154498
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jun 2022
Record last updated: 27 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.