Steven D Wilson, DDS
Individual provider Active NPI General Practice Dentistry · Tupper Lake, NY
NPI 1922020171 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922020171
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 032343 (NY)
- Practice address
- 34 Lake St
Tupper Lake, NY 12986-1611 - Phone
- (518) 359-9277
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 032343 | NY | Yes |
Addresses
Primary practice location
34 Lake St
Tupper Lake, NY 12986-1611
Mailing address
34 Lake St
Tupper Lake, NY 12986-1611
Phone (518) 359-9277
Other providers in Tupper Lake, NY
- Tupper Lake Volunteer Ambulance & Emergency Squad Inc
- Walgreen Co
- Matthew S Warner
- Melanie Werenczak
- Shelley Jean Whiteman I
- Howard Neal Ziegler
- Jessica Zobel
All providers in Tupper Lake, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.