Individual
DR. KEVIN J. WILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
111 BROADVIEW DR, GREEN BAY, WI 54301-2805
(920) 347-4560
Mailing address
111 BROADVIEW DR, GREEN BAY, WI 54301-2805
(920) 347-4560
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4522-015
WI
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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