Individual
BRETT M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2999 CORPORATE LN, SUFFOLK, VA 23434-8478
(757) 922-8110
(757) 922-8184
Mailing address
2999 CORPORATE LN, SUFFOLK, VA 23434-8478
(757) 922-8110
(757) 922-8184
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417013
VA
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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