Wilson, Bruce Taylor
Wilson, Bruce Taylor is an sole proprietor health care provider with primary practice located at 123 N 19Th Street , Middlesboro KY 40965-1786. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Wilson, Bruce Taylor can be contacted via phone (606) 248-1808.Contact Information
Primary practice address
123 N 19Th Street
Middlesboro KY 40965-1786
Phone: (606) 248-1808
Fax: (606) 248-1803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 5811 | Kentucky |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 5811 | Kentucky |
Profile Details
| NPI number | 1346294063 |
|---|---|
| LBN Legal business name | Wilson, Bruce Taylor |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346294063 | NPPES |
| Kentucky | MEDICAID | 64058118 | |
| Kentucky | MEDICAID | 60058112 |
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