Keith Jonathan Wilson, DDS
Dentist · Fort Drum, NY
Practice location
10590 Enduring Freedom DrUs Army Dental Activity
Fort Drum, NY 13602-5005
- Phone
- (315) 772-6234
NPI record
- NPI
- 1578621769
- Entity type
- Individual (Type 1)
- Enumeration date
- December 4, 2006
- Last updated
- June 13, 2016
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X |
0401008681 | VA |
About Dr. Wilson
Keith Jonathan Wilson, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005. The NPI number 1578621769 was assigned on December 4, 2006 and the record was last updated on June 13, 2016.
Dr. Wilson lists a license in the registry: #0401008681 (VA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Keith Jonathan Wilson, DDS?
The NPI number is 1578621769.
What is the phone number of Dr. Wilson?
The phone number listed for the practice location is (315) 772-6234.
Where is Dr. Wilson located?
10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005.
What is the taxonomy code for Dr. Wilson?
The primary taxonomy code is 122300000X – Dentist.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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