IndividualActive
Dustin Wilson, DDS, MS
NPI 1346521028 · Orthodontics and Dentofacial Orthopedics Dentistry · Jefferson City, MO
Provider details
- NPI number
- 1346521028
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- No
- License
- 2009013246 (MO)
Practice location
748 W Stadium Blvd
Suite 102
Jefferson City, MO 65109-4752
Phone: (573) 634-5122
Mailing address
748 W Stadium Blvd
Jefferson City, MO 65109-4752
Registry dates
- Enumerated
- 2011-09-08
- Last updated
- 2016-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.