Wilson, Courtney Lillianne

Wilson, Courtney Lillianne is an sole proprietor health care provider with primary practice located at 3285 Hacks Cross Rd Ste 101, Memphis TN 38125-8918. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Wilson, Courtney Lillianne can be contacted via phone (901) 759-0970.

Contact Information

Primary practice address
3285 Hacks Cross Rd Ste 101 Memphis TN 38125-8918
Phone: (901) 759-0970
Fax: (901) 759-0904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 8557 Tennessee

Profile Details

NPI number 1538382502
LBN Legal business name Wilson, Courtney Lillianne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2007
Last updated Oct 10th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538382502 NPPES
Tennessee MEDICAID 5440932

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