Organization
CHARLES BRENT WILSON DDS LLC
Active
Other names
St. Francisville Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BRENT WILSON DDS (OWNER)
(225) 454-9680
Entity
Organization
Contact information
Practice address
7689 US HWY 61, SAINT FRANCISVILLE, LA 70775-0820
(225) 635-6554
(225) 635-6239
Mailing address
PO BOX 474, 7689 US HWY 61, SAINT FRANCISVILLE, LA 70775-0474
(225) 635-6554
(225) 635-6239
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6033
LA
Other
Enumeration date
06/17/2010
Last updated
07/29/2013
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