Organization
ORTHODONTICS OF YUMA, P.C,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH A. WILSON DMD (OWNER)
(505) 325-8858
Entity
Organization
Contact information
Practice address
1030 W 24TH ST STE C-1, YUMA, AZ 85364-8319
(928) 343-9559
Mailing address
4760 N BUTLER AVE STE B1, FARMINGTON, NM 87401-0816
(505) 325-8858
(505) 325-2532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8613
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8613
AZ
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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