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NPI Code Detail

MEDICARE: DR. MICHAEL KEITH WILKERSON D.D.S., M.S.

MEDICARE:  DR. MICHAEL KEITH WILKERSON  D.D.S., M.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
11223P0221XPediatric Dentistry16232TX

General Provider Information

NPI Number : 1831240217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL KEITH WILKERSON D.D.S., M.S.
Provider Business Mailing Address
First Line : 4410 N MIDKIFF RD
Second Line : SUITE D-1
City : MIDLAND
State : TX
Zip : 79705-4246
Country : US
Telephone Number : 432-689-5437
Fax Number : 432-699-5719
Provider Business Practice Location Address
First Line : 4410 N MIDKIFF RD
Second Line : SUITE D-1
City : MIDLAND
State : TX
Zip : 79705-4246
Country : US
Telephone Number : 432-689-5437
Fax Number : 432-699-5719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL KEITH WILKERSON D.D.S., M.S.” Practice Location

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