Provider Demographics
NPI:1568661155
Name:WOLSKE, JILLIAN BARRAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:BARRAS
Last Name:WOLSKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 NEW CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3444
Mailing Address - Country:US
Mailing Address - Phone:910-251-8174
Mailing Address - Fax:910-341-3043
Practice Address - Street 1:4700 NEW CENTRE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3444
Practice Address - Country:US
Practice Address - Phone:910-251-8174
Practice Address - Fax:910-341-3043
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18051122300000X
NC8999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist