Individual
DR. BRETT MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5227 S MAIN ST, STE D, JOPLIN, MO 64804-4916
(417) 622-0004
(417) 553-7998
Mailing address
5227 S MAIN ST, STE D, JOPLIN, MO 64804-4916
(417) 622-0004
(417) 553-7998
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2005015029
MO
Other
Enumeration date
11/30/2005
Last updated
01/08/2014
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