RANDALL MARK WILK

GRETNA, LA
NPI1669578944
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
(Licence: LA  022962)
Additional Taxonomies1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: LA  4669)
Enumeration Date2006-09-15
Last Update Date2013-04-22
Business Address
RANDALL MARK WILK MD DDS PHD
120 MEADOWCREST ST. SUITE 300
GRETNA, LA 70056
Phone number: 504-362-6135
Mailing Address
RANDALL MARK WILK MD DDS PHD
120 MEADOWCREST ST. SUITE 300
GRETNA, LA 70056
Phone number: 504-362-6135