Cottam, Wayne Wilkinson

Cottam, Wayne Wilkinson is an individual health care provider with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dental Public Health. Dental Providers / Dental Public Health is his primary health care specialty. Cottam, Wayne Wilkinson can be contacted via phone (602) 263-1511.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Phone: (602) 263-1511
Fax: (602) 263-1637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D7446 Oregon
Dental Providers / General Practice 1223G0001X D3102 Idaho
Dental Providers / Dental Public Health 1223D0001X 272632-9922 Utah

Profile Details

NPI number 1003988064
LBN Legal business name Cottam, Wayne Wilkinson
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Oct 8th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003988064 NPPES
Arizona MEDICAID 857740
Arizona Other 0410520

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