Individual
JOSEPH W. WILKES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1122
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14190
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014822
NEIGHBORHOOD HEALTH PLAN
MA
01
—
053896
TUFTS HEALTH PLAN
MA
01
—
6245667-002
CIGNA
MA
01
—
J04037
BLUE CROSS
MA
01
—
PH126
HARVARD PILGRIM
MA
01
—
X04592
BCBS DENTAL
MA
Enumeration date
05/04/2006
Last updated
07/21/2022
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