Provider Demographics
NPI:1659861821
Name:TALMADGE W WILKINS III DMD - SDA LLC
Entity Type:Organization
Organization Name:TALMADGE W WILKINS III DMD - SDA LLC
Other - Org Name:DR. TALMADGE W. WILKINS III, DMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE MGR & CRED SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-552-1823
Mailing Address - Street 1:417 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-1902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:417 E MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-1902
Practice Address - Country:US
Practice Address - Phone:470-552-1823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty