Individual
DR. BRIAN MICHAEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2709 S. I-35 FRONTAGE ROAD SUITE B, MOORE, OK 73160
(405) 237-4979
Mailing address
2709 S. I-35 FRONTAGE ROAD SUITE B, MOORE, OK 73160
(405) 237-4979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6679
OK
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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