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Individual

DR. KEITH WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
713 S 42ND ST, MT VERNON, IL 62864
(618) 244-9666
(618) 244-9986
Mailing address
713 S 42ND ST, MT VERNON, IL 62864
(618) 244-9666
(618) 244-9986

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IL

Other

Enumeration date
04/03/2007
Last updated
07/08/2007
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