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General NPI Number Information
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NPI Number | 1861824344
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Entity Type | Individual
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Provider Name | BRITTANY WILSON DDS
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 1707 W CHARLESTON BLVD SUITE 290
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City | LAS VEGAS
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State | NV
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Zip | 89102-2351
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Country | US
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Telephone | 702-671-5175
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Fax |
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Provider Business Mailing Address
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Address Line | 650 S TOWN CENTER DR APT. 2068
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City | LAS VEGAS
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State | NV
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Zip | 89144-4419
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Country | US
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Telephone | 719-291-4219
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | LL-353-13
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License Number State | NV
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