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General NPI Number Information
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NPI Number | 1225017338
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Entity Type | Individual
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Provider Name | CALVIN JAMES WILSON DDS
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 3450 OLD WASHINGTON RD STE 301
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City | WALDORF
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State | MD
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Zip | 20602-3251
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Country | US
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Telephone | 240-448-6224
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 OLD WASHINGTON RD STE 301
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City | WALDORF
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State | MD
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Zip | 20602-3251
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Country | US
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Telephone | 240-448-6224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN03453
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12545
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License Number State | MD
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