Wilson, Jeremy T

Wilson, Jeremy T is an individual health care provider with primary practice located at 2301 E Lake Mead Blvd , North Las Vegas NV 89030-7137. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wilson, Jeremy T can be contacted via phone (702) 331-8338.

Contact Information

Primary practice address
2301 E Lake Mead Blvd North Las Vegas NV 89030-7137
Phone: (702) 331-8338
Fax: (702) 639-0579
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5090 Nevada

Profile Details

NPI number 1023186095
LBN Legal business name Wilson, Jeremy T
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jun 15th, 2016 - about 8 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 1023186095 NPPES
Nevada MEDICAID 1023186095
Nevada MEDICAID 100510344

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