Provider Demographics
NPI:1326888470
Name:WILKINS, SIDNEY CAROLINE (DDS)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:CAROLINE
Last Name:WILKINS
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 1:7208 WALDEN RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8546
Mailing Address - Country:US
Mailing Address - Phone:870-450-4779
Mailing Address - Fax:
Practice Address - Street 1:136 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-9072
Practice Address - Country:US
Practice Address - Phone:888-710-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR47431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice