Provider Demographics
NPI:1780756221
Name:WILCOX, WARREN CRAIG JR (DDS)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:CRAIG
Last Name:WILCOX
Suffix:JR
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 1:13 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5411
Mailing Address - Country:US
Mailing Address - Phone:304-242-8460
Mailing Address - Fax:304-243-0740
Practice Address - Street 1:& POINT VIEW TERRACE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-0740
Practice Address - Fax:304-243-0740
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice