Individual
NICHOLAS JON WILSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2653 LOCUST ST, SAINT LOUIS, MO 63103-1411
(314) 645-6451
Mailing address
818 OAK KNOLL RD, ROLLA, MO 65401-4714
(573) 201-4732
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2023023194
MO
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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