Individual
DR. KENNETH E WILSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6831 S CENTRAL AVE, PHOENIX, AZ 85042-5420
(602) 268-8881
Mailing address
6831 S CENTRAL AVE, PHOENIX, AZ 85042-5420
(602) 268-8881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008102
AZ
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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