IndividualActive
David Wilson, DMD, MD
NPI 1376705038 · Oral and Maxillofacial Surgery (Dentist) · Portage, MI
Provider details
- NPI number
- 1376705038
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DMD, MD
- Sex
- Male
- Sole proprietor
- No
- License
- 4301100207 (MI)
Specialties & taxonomies
Dental Providers
Allopathic & Osteopathic Physicians
Practice location
3801 Glenkerry Ct Ste 2
Portage, MI 49024-0711
Phone: (269) 323-1527
Approximate (ZIP-level) locationGet directions
Mailing address
3801 Glenkerry Ct Ste 2
Portage, MI 49024-0711
Registry dates
- Enumerated
- 2008-06-25
- Last updated
- 2020-10-20
- Certified
- 2020-10-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.