Organization
BRETT WILSON DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT MICHAEL WILSON (DENTIST)
(417) 622-0004
Entity
Organization
Contact information
Practice address
5227 S MAIN ST STE D, JOPLIN, MO 64804-4916
(417) 622-0004
Mailing address
5227 S MAIN ST STE D, JOPLIN, MO 64804-4916
(417) 622-0004
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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