# SIMPLY DENTAL & ORAL SURGERY PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578969754
- **Authorized official:** JOSEPH A WILSON DMD, MSD, LLC (OWNER)
- **Authorized official phone:** (505) 360-9592

## Contact information

- **Practice address:** 4760 N BUTLER AVE STE B1, FARMINGTON, NM 87401-0816
- **Practice address phone:** (505) 325-8858
- **Mailing address:** 4760 N BUTLER AVE STE B1, FARMINGTON, NM 87401-0816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DD3399 | NM | Yes |

## Other

- **Enumeration date:** 11/14/2014
- **Last updated:** 11/14/2014