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Organization

DR. JOSEPH A. WILSON DMD, MSD, LLC

Active
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Organization

DR. JOSEPH A. WILSON DMD, MSD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH A WILSON DMD MSD LLC (OWNER)
(702) 469-3590
Entity
Organization

Contact information

Practice address
4760 N BUTLER AVE STE A, FARMINGTON, NM 87401-0816
(702) 469-3590
(702) 469-3590
Mailing address
4760 N BUTLER AVESUITE A, FARMINGTON, NM 87401
(702) 469-3590
(702) 469-3590

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD3399
NM

Other

Enumeration date
03/29/2011
Last updated
03/29/2011
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