Organization · Type 2 NPI
Dr. Bruce T. Wilson D.d.s., PA
Dental Clinic/Center · Manila, AR
NPI number
1821686684
Active
Practice location
3455 W State Highway 18
Manila, AR 72442-8005
Fax (870) 561-4037
Mailing address
PO Box 1345
Manila, AR 72442-1345
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
About NPI 1821686684
Dr. Bruce T. Wilson D.d.s., PA's National Provider Identifier is 1821686684, issued on Jan 7, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Manila, AR. The record was last updated on Jan 7, 2021.