Provider Demographics
NPI:1972640530
Name:WILKOP, CAROL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:WILKOP
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 1:435 N MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1960
Mailing Address - Country:US
Mailing Address - Phone:248-685-2035
Mailing Address - Fax:248-684-2077
Practice Address - Street 1:435 N MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1960
Practice Address - Country:US
Practice Address - Phone:248-685-2035
Practice Address - Fax:248-684-2077
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist