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General NPI Number Information
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NPI Number | 1316812670
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Entity Type | Organization
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Legal Business Name | GABRIELA WILSON DMD LLC
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 102 HARDING WAY W
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City | GALION
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State | OH
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Zip | 44833-1700
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Country | US
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Telephone | 419-468-4285
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 PINE GROVE CT
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City | MANSFIELD
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State | OH
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Zip | 44906-3519
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | GABRIELA WILSON
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Credential | DMD
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Telephone | 216-544-8126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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