| Dr. Bruce T. Wilson D.d.s., Pa | |
|
3455 W State Highway 18 Manila AR 72442-8005 | |
| (870) 561-4400 | |
| (870) 561-4037 |
| Full Name | Dr. Bruce T. Wilson D.d.s., Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3455 W State Highway 18, Manila, Arkansas |
| Authorized Official Name and Position | Tanya Mccain (OFFICE MANAGER) |
| Authorized Official Contact | 8705614400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Bruce T. Wilson D.d.s., Pa Po Box 1345 Manila AR 72442-1345 Ph: (870) 561-4400 | Dr. Bruce T. Wilson D.d.s., Pa 3455 W State Highway 18 Manila AR 72442-8005 Ph: (870) 561-4400 |
| NPI Number | 1821686684 |
|---|---|
| Provider Enumeration Date | 01/07/2021 |
| Last Update Date | 01/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821686684 | NPI | - | NPPES |
| 180606608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |