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NPI Code Detail

MEDICARE: BOYD WILSON

MEDICARE: BOYD WILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN122248GA

General Provider Information

NPI Number : 1699373928
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOYD WILSON
Provider Business Mailing Address
First Line : 1685 MARS HILL RD NW STE 200
Second Line :
City : ACWORTH
State : GA
Zip : 30101-7180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1685 MARS HILL RD NW STE 200
Second Line :
City : ACWORTH
State : GA
Zip : 30101-7180
Country : US
Telephone Number : 770-919-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2020
Last Update Date : 12/21/2025

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Directions to “ BOYD WILSON ” Practice Location

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