Provider Demographics
NPI:1447406277
Name:WILGES, JOSHUA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:M
Last Name:WILGES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 45TH ST
Mailing Address - Street 2:#1708
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4212
Mailing Address - Country:US
Mailing Address - Phone:646-590-2100
Mailing Address - Fax:
Practice Address - Street 1:2 W 45TH ST
Practice Address - Street 2:#1708
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4212
Practice Address - Country:US
Practice Address - Phone:646-590-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50-0541081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice