IndividualActive
J Wilson, DDS
NPI 1235286493 · General Practice Dentistry · Flora, IL
Provider details
- NPI number
- 1235286493
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 019023059 (IL)
Specialties & taxonomies
Dental Providers
Practice location
317 E North Ave
Flora, IL 62839-2040
Phone: (618) 662-6907
Fax: (618) 662-7135
Approximate (ZIP-level) locationGet directions
Mailing address
317 E North Ave
Flora, IL 62839-2040
Registry dates
- Enumerated
- 2007-01-03
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.