Organization
T. PALMER WILKS, JR., D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T. PALMER WILKS JR. D.M.D. (PRESIDENT)
(601) 856-4110
Entity
Organization
Contact information
Practice address
213 HOY RD, MADISON, MS 39110-8709
(601) 856-4110
(601) 856-8109
Mailing address
PO BOX 859, MADISON, MS 39130-0859
(601) 856-4110
(601) 856-8109
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2304-86
MS
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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