Provider Demographics
NPI:1467566349
Name:WILKINS, JON SHARP (DDS, MSD,PA)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:SHARP
Last Name:WILKINS
Suffix:
Gender:M
Credentials:DDS, MSD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 W MORSE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3794
Mailing Address - Country:US
Mailing Address - Phone:407-644-0177
Mailing Address - Fax:407-644-8839
Practice Address - Street 1:731 W MORSE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3794
Practice Address - Country:US
Practice Address - Phone:407-644-0177
Practice Address - Fax:407-644-8839
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN61831223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics