Individual
GENE RAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1407 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-0157
(573) 778-3042
(573) 778-9432
Mailing address
PO BOX 157, ELLINGTON, MO 63638-0157
(573) 663-2313
(573) 663-2322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012964
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12964
DELTA DENTAL
MO
05
—
407270917
—
MO
Enumeration date
10/04/2006
Last updated
03/01/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us