Individual
DR. JACK LEE WILHELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5503 OLEANDER DR, WILMINGTON, NC 28403-5813
(910) 392-1905
(910) 392-0462
Mailing address
5503 OLEANDER DR, WILMINGTON, NC 28403-5813
(910) 392-1905
(910) 392-0462
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4968
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
545685
UNITED CONCORDIA
NC
05
—
8999283
—
NC
Enumeration date
01/18/2007
Last updated
07/08/2007
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