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General NPI Number Information
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NPI Number | 1659740140
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Entity Type | Organization
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Legal Business Name | WILKINSON FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 9015 FOREST HILL AVE
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-3050
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Country | US
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Telephone | 804-272-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 9015 FOREST HILL AVE
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-3050
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Country | US
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Telephone | 804-272-6800
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DAVID WILKINSON
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Credential | DDS
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Telephone | 804-272-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401410269
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License Number State | VA
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