Provider Demographics
NPI:1881817898
Name:WILSON, STEVEN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:WILSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 W TROPICANA AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8131
Mailing Address - Country:US
Mailing Address - Phone:702-257-9444
Mailing Address - Fax:702-967-8005
Practice Address - Street 1:8910 W TROPICANA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8131
Practice Address - Country:US
Practice Address - Phone:702-257-9444
Practice Address - Fax:702-967-8005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist