Individual
ALLEN RANDY WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15 SIERRA GATE PLZ, ROSEVILLE, CA 95678-6602
(916) 786-6777
Mailing address
15 SIERRA GATE PLZ, ROSEVILLE, CA 95678-6602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30985
CA
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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