| Bruce T. Wilson,d.m.d., Psc | |
|
123 N 19th St Middlesboro KY 40965-2865 | |
| (606) 248-1808 | |
| (606) 248-1803 |
| Full Name | Bruce T. Wilson,d.m.d., Psc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 123 N 19th St, Middlesboro, Kentucky |
| Authorized Official Name and Position | Bruce Taylor Wilson (PRESIDENT) |
| Authorized Official Contact | 6062481808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce T. Wilson,d.m.d., Psc 123 N 19th St Po Box 1786 Middlesboro KY 40965-2865 Ph: (606) 248-1808 | Bruce T. Wilson,d.m.d., Psc 123 N 19th St Middlesboro KY 40965-2865 Ph: (606) 248-1808 |
| NPI Number | 1396924544 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 10/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396924544 | NPI | - | NPPES |
| 64058118 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5811 (Kentucky) | Primary |
Richard D Barnett Dmd Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 S 10th St, Middlesboro, KY 40965 Phone: 606-248-7505 | |
Mountain Dental Care, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2004 Cumberland Avenue, Apex Medical Building Suite333, Middlesboro, KY 40965 Phone: 276-870-8081 |