Organization
FULTON DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM MICHAEL WILKIN D.D.S. (OWNER)
(815) 589-4007
Entity
Organization
Contact information
Practice address
1130 17TH ST, FULTON, IL 61252-2008
(815) 589-4007
(815) 589-4897
Mailing address
1130 17TH ST, FULTON, IL 61252-2008
(815) 589-4007
(815) 589-4897
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004190
—
IL
05
—
1004473
—
IL
Enumeration date
02/25/2008
Last updated
09/23/2008
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