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1770844359
JERELL JAMES WILSON
LAWRENCE, KS
NPI
1770844359
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: MO 2012015521)
Enumeration Date
2012-05-31
Last Update Date
2014-06-30
Business Address
-- JERELL JAMES WILSON D.D.S
316 MAINE ST
LAWRENCE, KS 66044-1359
Phone number: 785-312-7770
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Mailing Address
-- JERELL JAMES WILSON D.D.S
1811 ZUMBEHL RD
SAINT CHARLES, MO 63303-2728
Phone number: 636-947-1800
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