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Dr. Bruce T. Wilson D.d.s., Pa
Dental Clinic/Center in Manila, Arkansas
NPI 1821686684

Dr. Bruce T. Wilson D.d.s., Pa is a Dental Clinic/Center based in Manila, AR and is specialized in Dental. Dr. Bruce T. Wilson D.d.s., Pa practices in Manila, AR. The NPI Number for Dr. Bruce T. Wilson D.d.s., Pa is 1821686684 and holds a License No. (Arkansas).

The current practice location address for Dr. Bruce T. Wilson D.d.s., Pa is 3455 W State Highway 18, Manila, AR and can be reached out via phone at 870-561-4400 and via fax at 870-561-4037.

Location: 3455 W State Highway 18, Manila, AR, 72442-1345
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1821686684
Provider Name
Dr. Bruce T. Wilson D.d.s., Pa
Credential
Provider Entity Type
Organization
Address
3455 W State Highway 18, Manila, AR, 72442-1345
Phone Number
870-561-4400
Fax Number
870-561-4037
Provider Enumeration Date
01/07/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
180606608 05 AR
institution
Provider Business Practice Location Address Details
Address
3455 W State Highway 18
City
Manila
State
Arkansas
Zip
72442-8005
Phone Number
870-561-4400
Fax Number
870-561-4037
person
Provider Business Mailing Address Details
Address
3455 W State Highway 18
City
Manila
State
Arkansas
Zip
72442-8005
Phone Number
870-561-4400
Fax Number
870-561-4037
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
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Definition
Definition to come...
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