Organization
RICHARD DREW DDS & J 'GUS' WILSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF WILSON DDS (DENTIST)
(405) 632-6601
Entity
Organization
Contact information
Practice address
1044 SW 44TH ST, SUITE 510, OKLAHOMA CITY, OK 73109-3613
(405) 632-6601
(405) 632-6031
Mailing address
1044 SW 44TH ST, SUITE 510, OKLAHOMA CITY, OK 73109-3613
(405) 632-6601
(405) 632-6031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5039
OK
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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