| T. Palmer Wilks, Jr., D.m.d., P.a. | |
|
213 Hoy Rd Madison MS 39110-8709 | |
| (601) 856-4110 | |
| (601) 856-8109 |
| Full Name | T. Palmer Wilks, Jr., D.m.d., P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 213 Hoy Rd, Madison, Mississippi |
| Authorized Official Name and Position | T. Palmer Wilks (PRESIDENT) |
| Authorized Official Contact | 6018564110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T. Palmer Wilks, Jr., D.m.d., P.a. Po Box 859 Madison MS 39130-0859 Ph: (601) 856-4110 | T. Palmer Wilks, Jr., D.m.d., P.a. 213 Hoy Rd Madison MS 39110-8709 Ph: (601) 856-4110 |
| NPI Number | 1306018619 |
|---|---|
| Provider Enumeration Date | 03/26/2008 |
| Last Update Date | 03/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306018619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2304-86 (Mississippi) | Primary |
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