Healthcare Provider Details

I. General information

NPI: 1538128426
Provider Name (Legal Business Name): DAVID ARTHUR WILCOX DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9045 VIA AMORITA
DOWNEY CA
90241-2749
US

IV. Provider business mailing address

MED CO. 1SB UNIT 31530
APO AE
09833
EG

V. Phone/Fax

Practice location:
  • Phone: 562-923-5920
  • Fax:
Mailing address:
  • Phone: 11-972-8628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00010095
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: