Individual
PATRICK R WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6744 CLAYTON RD, STE 216, SAINT LOUIS, MO 63117-1634
(314) 645-1337
(314) 645-5652
Mailing address
6744 CLAYTON RD, STE 216, SAINT LOUIS, MO 63117-1634
(314) 645-1337
(314) 645-5652
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN 011921
MO
Other
Enumeration date
06/01/2005
Last updated
07/08/2007
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