# CHARLES BRENT WILSON DDS LLC

> 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
- **Other names:** St. Francisville Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962723502
- **Authorized official:** DR. CHARLES BRENT WILSON DDS (OWNER)
- **Authorized official phone:** (225) 454-9680

## Contact information

- **Practice address:** 7689 US HWY 61, SAINT FRANCISVILLE, LA 70775-0820
- **Practice address phone:** (225) 635-6554
- **Practice address fax:** (225) 635-6239
- **Mailing address:** PO BOX 474, 7689 US HWY 61, SAINT FRANCISVILLE, LA 70775-0474
- **Mailing address phone:** (225) 635-6554
- **Mailing address fax:** (225) 635-6239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6033 | LA | Yes |

## Other

- **Enumeration date:** 06/17/2010
- **Last updated:** 07/29/2013