Individual
MARCUS ALLEN WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1048 UNION ST, BANGOR, ME 04401-3016
(207) 992-2152
(207) 992-2154
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2009013195
MO
122300000X
Dentist
Primary
DEN4256
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DEN4256
LICENSE
ME
Enumeration date
06/02/2009
Last updated
05/17/2013
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