Provider Demographics
NPI:1184153991
Name:WILSON WESTMARK, NANCY ADALYN (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ADALYN
Last Name:WILSON WESTMARK
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:ADALYN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MPH
Mailing Address - Street 1:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIRCLE
Practice Address - Street 2:CLINIC 1F
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-660-1263
Practice Address - Fax:919-684-5188
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858243122300000X
SC9662122300000X
NC0239122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist