Julia Marie Wilson, DMD

Individual provider Active NPI General Practice Dentistry · Brewster, MA

NPI 1053972083 · NPPES record last updated Jan 9, 2024

Key facts

NPI
1053972083
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN1858356 (MA)
Practice address
2187 Main St
Brewster, MA 02631-1817
Phone
(508) 896-5951
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN1858356MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Breakwater Dental, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1858356 MA Yes

Addresses

Primary practice location

2187 Main St
Brewster, MA 02631-1817

Mailing address

PO Box 174
Hyannis Port, MA 02647
Phone (774) 265-5475

Other names

  • Julia Marie Ariola Former name

Other providers in Brewster, MA

All providers in Brewster, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.