Individual
DR. FREDDIE EARL WILKES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2154 GOODMAN RD W # 1, HORN LAKE, MS 38637-1303
(662) 392-9200
Mailing address
3451 GOODMAN RD E STE 122, SOUTHAVEN, MS 38672-9302
(662) 892-8565
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
RES.3249
OH
1223P0221X
Pediatric Dentistry
Primary
4346-22
MS
Other
Enumeration date
07/31/2012
Last updated
03/07/2023
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