DR. Brian Michael Wilson, DDS

NPI #1962882373 in Moore, Oklahoma

Provider Information

NPI Number: 1962882373
Entity Type: Individual
Name: DR. Brian Michael Wilson, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jun 2, 2015
Last Updated: Jun 2, 2015

Practice Location

Address: 2709 S. I-35 FRONTAGE ROAD SUITE B
City: Moore
State: Oklahoma
ZIP Code: 73160
Phone: (405) 237-4979

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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