Individual
DR. BRETT ALLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
875 UNION AVE, MEMPHIS, TN 38163-1900
(901) 448-6233
(901) 448-5480
Mailing address
374 W PARK DR, FULTONDALE, AL 35068-6073
(580) 243-7865
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11506
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2015
Last updated
08/04/2022
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