NPI 1003015496

Kenneth Byron Wiltbank, DMD

Practitioner Dentist Lake Oswego, OR

Practice location

Address: 320 a Ave, Lake Oswego, OR 97034-3056
Phone: (503) 636-3383
Mailing address: 320 a Avenue, Lake Oswego, OR 97034

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D7468 (OR)

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Registry record

NPI: 1003015496
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jul 2007
Record last updated: 16 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.