Provider Demographics
NPI:1275582546
Name:WILMOT, JANICE JONES (DMD, MS)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:JONES
Last Name:WILMOT
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 KILLIAN HILL RD SW
Mailing Address - Street 2:SUITE D
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3102
Mailing Address - Country:US
Mailing Address - Phone:770-921-2233
Mailing Address - Fax:770-921-6090
Practice Address - Street 1:956 KILLIAN HILL RD SW
Practice Address - Street 2:SUITE D
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3102
Practice Address - Country:US
Practice Address - Phone:770-921-2233
Practice Address - Fax:770-921-6090
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0104051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics