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General NPI Number Information
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NPI Number | 1285071829
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Entity Type | Organization
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Legal Business Name | N. STEPHEN WILSON, D.D.S.
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 4635 RICHMOND RD STE 100
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City | CLEVELAND
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State | OH
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Zip | 44128-5938
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Country | US
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Telephone | 216-514-6205
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Fax | 216-514-6207
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Provider Business Mailing Address
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Address Line | 4635 RICHMOND RD STE 100
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City | CLEVELAND
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State | OH
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Zip | 44128-5938
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Country | US
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Telephone | 216-514-6205
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Fax | 216-514-6207
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Authorized Official
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Title or Position | OWNER
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Name | DR. NAPOLEON STEPHEN WILSON
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Credential | D.D.S.
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Telephone | 21551546205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-015232
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License Number State | OH
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