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General NPI Number Information
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NPI Number | 1285946954
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Entity Type | Individual
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Provider Name | AMY DUNLAP WILSON D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 7 SNOW ST
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City | OXFORD
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State | AL
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Zip | 36203-1276
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Country | US
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Telephone | 256-831-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 5TH AVE S
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City | IRONDALE
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State | AL
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Zip | 35210-2004
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Country | US
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Telephone | 205-960-4189
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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 | 5784
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License Number State | AL
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