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NPI Code Detail

MEDICARE: WILKESBORO AMY KINLAW PLLC

MEDICARE: WILKESBORO AMY KINLAW PLLC
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
11223P0221XPediatric Dentistry

General Provider Information

NPI Number : 1801533120
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILKESBORO AMY KINLAW PLLC
Provider Business Mailing Address
First Line : 200 W PARK CIR STE C
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3583
Country : US
Telephone Number : 336-568-7700
Fax Number :
Provider Business Practice Location Address
First Line : 200 W PARK CIR STE C
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3583
Country : US
Telephone Number : 336-568-7700
Fax Number :
Authorized Official
Title or Position : OWNER/DENTIST
Name : AMY ANN KINLAW
Credential : DMD
Telephone Number : 336-568-7700
Provider Enumeration Date : 05/18/2022
Last Update Date : 11/05/2024

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