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Individual

DR. BRIAN CHARLES WILKERSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
831 VERMONT ST, LAWRENCE, KS 66044-2665
(785) 843-6060
(785) 843-4335
Mailing address
831 VERMONT ST, LAWRENCE, KS 66044-2665
(785) 843-6060
(785) 843-4335

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6273
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116687
BC/BS OF KS
KS
01
12754020
BC/BS OF KANSAS CITY
MO
Enumeration date
02/01/2006
Last updated
07/08/2007
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