Provider Demographics
NPI:1902021934
Name:VILICAN, GEORGE RADNOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RADNOR
Last Name:VILICAN
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 1:1000 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-3735
Mailing Address - Country:US
Mailing Address - Phone:828-693-6137
Mailing Address - Fax:828-698-6377
Practice Address - Street 1:1000 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-3735
Practice Address - Country:US
Practice Address - Phone:828-693-6137
Practice Address - Fax:828-698-6377
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5883OtherDENTAL LIC