institution
Tracy L. Wilkerson, Dds, Pllc
Pediatric Dentist in Charleston, West Virginia
NPI 1760501001

Tracy L. Wilkerson, Dds, Pllc is a Pediatric Dentist based in Charleston, WV and is specialized in Pediatric Dentistry. Tracy L. Wilkerson, Dds, Pllc practices in Charleston, WV. The NPI Number for Tracy L. Wilkerson, Dds, Pllc is 1760501001 and holds a License No. 3529 (West Virginia).

The current practice location address for Tracy L. Wilkerson, Dds, Pllc is 1400 Kanawha Blvd E, Charleston, WV and can be reached out via phone at 304-345-0541 and via fax at 304-345-8718.

Location: 1400 Kanawha Blvd E, Charleston, WV, 25301-3002
institution
Provider Profile Details
NPI Number
1760501001
Provider Name
Tracy L. Wilkerson, Dds, Pllc
Credential
Provider Entity Type
Organization
Address
1400 Kanawha Blvd E, Charleston, WV, 25301-3002
Phone Number
304-345-0541
Fax Number
304-345-8718
Provider Enumeration Date
03/28/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1528024460 01 WV INDIVIDUAL NPI
4005111000 05 WV
3810005586 05 WV
institution
Provider Business Practice Location Address Details
Address
1400 Kanawha Blvd E
City
State
Zip
25301-3002
Phone Number
304-345-0541
Fax Number
304-345-8718
person
Provider Business Mailing Address Details
Address
1400 Kanawha Blvd E
City
State
Zip
25301-3002
Phone Number
304-345-0541
Fax Number
304-345-8718
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
3529 (West Virginia)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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