Wilson, Keith Jonathan
Wilson, Keith Jonathan is an sole proprietor health care provider with primary practice located at 10590 Enduring Freedom Dr Us Army Dental Activity, Fort Drum NY 13602-5005. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wilson, Keith Jonathan can be contacted via phone (315) 772-6234.Contact Information
Primary practice address
10590 Enduring Freedom Dr Us Army Dental Activity
Fort Drum NY 13602-5005
Phone: (315) 772-6234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0401008681 | Virginia |
Profile Details
| NPI number | 1578621769 |
|---|---|
| LBN Legal business name | Wilson, Keith Jonathan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jun 13th, 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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