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Organization

DONALD B. WILCOXON D.D.S, M.S., PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD WILCOXON D.D.S., M.S. (OWNER PRESIDENT)
(913) 661-9901
Entity
Organization

Contact information

Practice address
4601 W 109TH ST, SUITE 310, OVERLAND PARK, KS 66211-1318
(913) 661-9901
(913) 661-9702
Mailing address
4601 W 109TH ST, SUITE 310, OVERLAND PARK, KS 66211-1318
(913) 661-9901
(913) 661-9702

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6068
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13166
STATE LICENSE
MO
01
6068
STATE LICENSE
KS
Enumeration date
01/26/2007
Last updated
08/22/2020
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