Individual
ELIZABETH BROOKE WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 W PARK LN STE 110, FARMINGTON, UT 84025-2994
(801) 797-0069
Mailing address
16124 HOWARD LANDING DR, GAITHERSBURG, MD 20878-2262
(301) 300-8151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13395841-9922
UT
122300000X
Dentist
13395841-9926
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
03/07/2024
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