Provider Demographics
NPI:1376681965
Name:WILSON, ARLENE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:MARIE
Last Name:WILSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-306-5195
Mailing Address - Fax:301-306-5197
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-306-5195
Practice Address - Fax:301-306-5197
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice