Organization
WILKES DENTAL CONSORTIUM INC
Active
Other names
Wilkes Public Health Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERALD H. ATKINS (OFFICE MANAGER)
(336) 903-7302
Entity
Organization
Contact information
Practice address
1915 WEST PARK DR, SUITE 104, N WILKESBORO, NC 28659-3777
(336) 903-7302
(336) 903-0464
Mailing address
1915 WEST PARK DR, SUITE 104, N WILKESBORO, NC 28659-3777
(336) 903-7302
(336) 903-0464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07095
INSURANCE
NC
Enumeration date
09/09/2006
Last updated
10/26/2007
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