| NPI | 1770871600 |
|---|---|
| Former Legal Business Name | WILSON DENTAL GROUP OF ALBANY PC |
| Entity Type | Organization |
| Authorized Contact | JASON NICOLETTI Owner Doctor 518-435-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 052806) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-05-10 |