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Contact Information

GREGORY L WILSON, DDS MS
710 FEDERAL DRIVE
SELMER, TN38375
 Phone: 731-645-7506
 Fax: 731-645-5660
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for GREGORY L WILSON · (Male)

NPI # 1447386875
Status Active
Credentials DDS MS
Entity Individual
Enumeration date 02/27/2007
Last updated 11/30/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • TN License # DS3832
  • TN Medicaid 3226180
  • Other 792419 UNITED CONCORDIA
  • TN Other 0106853 BLUE CROSS BLUE SHIELD
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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