# BRIAN H. WILLSON, D.D.S., P.A.

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

## Provider details

- **NPI number:** 1760495832
- **Authorized official:** BRIAN H WILLSON D.D.S. (PRESIDENT)
- **Authorized official phone:** (910) 484-1555

## Contact information

- **Practice address:** 2019 VALLEYGATE DR, SUITE 101, FAYETTEVILLE, NC 28304-3688
- **Practice address phone:** (910) 484-1555
- **Practice address fax:** (910) 323-9287
- **Mailing address:** 2019 VALLEYGATE DR, SUITE 101, FAYETTEVILLE, NC 28304-3688
- **Mailing address phone:** (910) 484-1555
- **Mailing address fax:** (910) 323-9287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 08/22/2020