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Contact Information

SHELLEY A WILSON, DDS
2460 LAKESHORE DR
SAINT JOSEPH, MI49085-1874
 Phone: 269-983-5583
 Fax: 269-983-5663
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for SHELLEY A WILSON · (Female)

NPI # 1306874797
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 06/28/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 2901017656
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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