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1336150754
MICHAEL BRUCE WILSON
FULTON, MO
NPI
1336150754
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MO 014306)
Enumeration Date
2006-08-10
Last Update Date
2007-07-08
Business Address
-- MICHAEL BRUCE WILSON DDS
600 E 5TH STREET FULTON STATE HOSPITAL
FULTON, MO 65251
Phone number: 573-592-4100
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Mailing Address
-- MICHAEL BRUCE WILSON DDS
600 E 5TH ST
FULTON, MO 65251-1753
Phone number: 573-592-4100
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