Organization
SOUTH GEORGIA COSMETIC & GENERAL DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES STEVE WILKERSON DMD (MEMBER)
(912) 384-4432
Entity
Organization
Contact information
Practice address
1108 MADISON AVE N, DOUGLAS, GA 31533-2802
(912) 384-4432
Mailing address
1108 MADISON AVE N, DOUGLAS, GA 31533-2802
(912) 384-4432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10432
GA
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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