Provider Demographics
NPI:1003811936
Name:WILSON, FRANK WAYNE (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WAYNE
Last Name:WILSON
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 W MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-2537
Mailing Address - Country:US
Mailing Address - Phone:817-860-4343
Mailing Address - Fax:817-461-6273
Practice Address - Street 1:908 W MITCHELL ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-2537
Practice Address - Country:US
Practice Address - Phone:817-860-4343
Practice Address - Fax:817-461-6273
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice