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Contact Information

KENNETH B WILTBANK, DMD
320 A AVE
LAKE OSWEGO, OR97034-3056
 Phone: 503-636-3383
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for KENNETH B WILTBANK · (Male)

NPI Number 1003015496
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 07/16/2007
Last updated 07/16/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • OR License # D7468
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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