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NPI Code Detail

MEDICARE: DR. RONALD CARL WILCOX D.D.S.

MEDICARE:  DR. RONALD CARL WILCOX  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry009989GA

General Provider Information

NPI Number : 1114922382
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD CARL WILCOX D.D.S.
Provider Business Mailing Address
First Line : 1235 ROBINSON RD
Second Line : STE H
City : PEACHTREE CITY
State : GA
Zip : 30269-3832
Country : US
Telephone Number : 770-487-1880
Fax Number : 770-487-1851
Provider Business Practice Location Address
First Line : 1235 ROBINSON RD
Second Line : STE H
City : PEACHTREE CITY
State : GA
Zip : 30269-3832
Country : US
Telephone Number : 770-487-1880
Fax Number : 770-487-1851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 07/08/2007

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Directions to “ DR. RONALD CARL WILCOX D.D.S.” Practice Location

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