Individual
BRIAN L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2350 NW CENTURY DR, STE #200, CORVALLIS, OR 97330-3495
(541) 768-0419
(541) 768-0521
Mailing address
2350 NW CENTURY DR, STE #200, CORVALLIS, OR 97330-3495
(541) 768-0419
(541) 768-0521
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D7843
OR
Other
Enumeration date
07/11/2005
Last updated
01/24/2014
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