Provider Demographics
NPI:1891853503
Name:WILSON & PERKINS PC
Entity type:Organization
Organization Name:WILSON & PERKINS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-589-7595
Mailing Address - Street 1:524 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7441
Mailing Address - Country:US
Mailing Address - Phone:860-589-7595
Mailing Address - Fax:860-585-9550
Practice Address - Street 1:524 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-7441
Practice Address - Country:US
Practice Address - Phone:860-589-7595
Practice Address - Fax:860-585-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5806122300000X
CT5820122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty