Individual
DR. STEPHANIE LEE WILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2339
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417472
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2021
Last updated
08/19/2024
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