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General NPI Number Information
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NPI Number | 1447511159
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Entity Type | Individual
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Provider Name | GRAHAM H WILSON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 7320 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28411-9881
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Country | US
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Telephone | 910-386-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 7320 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28411-9881
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Country | US
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Telephone | 910-386-5003
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401415147
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License Number State | NC
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