Individual
DR. BRIAN J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17250 N 43RD AVE, STE 1, GLENDALE, AZ 85308
(602) 938-7750
(602) 938-0765
Mailing address
17250 N 43RD AVE, STE 1, GLENDALE, AZ 85308
(602) 938-7750
(602) 938-0765
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1826
AZ
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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