Individual
DR. ROSCOE WILKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2619 JASMINE ST, NEW ORLEANS, LA 70122-6017
(504) 304-0472
Mailing address
2619 JASMINE ST, NEW ORLEANS, LA 70122-6017
(504) 304-0472
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3797
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1837971
—
LA
Enumeration date
01/02/2008
Last updated
01/02/2008
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