Organization
ORTHODONTICS OF FLAGSTAFF PC
Active
Organization
ORTHODONTICS OF FLAGSTAFF PC
Active
Other names
Orthodontics, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH A WILSON DMD, MSD (OWNER)
(505) 325-8858
Entity
Organization
Contact information
Practice address
713 N BEAVER ST, FLAGSTAFF, AZ 86001-3142
(928) 774-0881
(928) 774-2029
Mailing address
4760 N BUTLER AVE STE A, FARMINGTON, NM 87401-0816
(505) 325-8858
(505) 325-2532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8613
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8613
AZ
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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