Individual
LESLIE LORRAINE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
16342 COUNTY ROAD 30, MAPLE GROVE, MN 55311-1207
(763) 420-9876
Mailing address
16342 COUNTY ROAD 30, MAPLE GROVE, MN 55311-1207
(763) 420-9876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9590
MN
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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