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Individual

TRAVIS CHARLES WILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
222 HEADTOWN RD, J ALLEN BURLESON DDS PC, JONESBOROUGH, TN 37659-0455
(423) 753-9191
(423) 753-9644
Mailing address
PO BOX 455, J ALLEN BURLESON DDS PC, JONESBOROUGH, TN 37659-0455
(423) 753-9191
(423) 753-9644

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8721
TN

Other

Enumeration date
08/23/2007
Last updated
08/23/2007
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