Individual
DR. KONITA LEE WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
10602 CHAPMAN AVE, GARDEN GROVE, CA 92840-3146
(714) 537-0700
Mailing address
6021 KENWICK CIR, HUNTINGTON BEACH, CA 92648-1036
(714) 642-5200
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
63433
CA
Other
Enumeration date
06/12/2014
Last updated
11/08/2015
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