Individual
MYRON KEITH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
739 BLUFF CITY HWY, BRISTOL, TN 37620-4637
(423) 652-2624
(423) 968-9471
Mailing address
739 BLUFF CITY HWY, BRISTOL, TN 37620-4637
(423) 652-2624
(423) 968-9471
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
004698
TN
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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