Provider Demographics
NPI:1659740140
Name:WILKINSON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WILKINSON FAMILY DENTISTRY
Other - Org Name:CLAUDE M WILKINSON & ASSOC, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-272-6800
Mailing Address - Street 1:9015 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3050
Mailing Address - Country:US
Mailing Address - Phone:804-272-6800
Mailing Address - Fax:
Practice Address - Street 1:9015 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3050
Practice Address - Country:US
Practice Address - Phone:804-272-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty