Individual
DR. KELLY C WILKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2274 NORTH 400 EAST, SUITE 204, OGDEN, UT 84414-7241
(801) 399-0458
Mailing address
2274 NORTH 400 EAST, SUITE 204, OGDEN, UT 84414-7241
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7190754-9921
UT
1223G0001X
General Practice Dentistry
D7583
AZ
Other
Enumeration date
07/07/2008
Last updated
03/03/2009
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