Provider Demographics
NPI:1417050493
Name:WILKINS, CHARLES EDWARD III (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EDWARD
Last Name:WILKINS
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:14811 BEAR CREEK PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-8937
Mailing Address - Country:US
Mailing Address - Phone:512-301-1388
Mailing Address - Fax:512-454-5050
Practice Address - Street 1:5020 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2612
Practice Address - Country:US
Practice Address - Phone:512-454-1010
Practice Address - Fax:512-454-5050
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX134251223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics