| Fulton Dental Associates Pc | |
|
1130 17th St Fulton IL 61252-2008 | |
| (815) 589-4007 | |
| (815) 589-4897 |
| Full Name | Fulton Dental Associates Pc |
|---|---|
| Speciality | Dentist |
| Location | 1130 17th St, Fulton, Illinois |
| Authorized Official Name and Position | William Michael Wilkin (OWNER) |
| Authorized Official Contact | 8155894007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulton Dental Associates Pc 1130 17th St Fulton IL 61252-2008 Ph: (815) 589-4007 | Fulton Dental Associates Pc 1130 17th St Fulton IL 61252-2008 Ph: (815) 589-4007 |
| NPI Number | 1154590040 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 09/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154590040 | NPI | - | NPPES |
| 1004473 | Medicaid | IL | |
| 1004190 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
Wilkin & Kunau Dentistry Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 17th St, Fulton, IL 61252 Phone: 815-589-4007 Fax: 815-589-4897 |