Larry J Whisenant Pc | |
121 10th St Nw Vernon AL 35592 | |
(205) 695-7171 | |
(205) 695-0801 |
Full Name | Larry J Whisenant Pc |
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Speciality | Dentist |
Location | 121 10th St Nw, Vernon, Alabama |
Authorized Official Name and Position | Larry Joe Whisenant (OWNER DENTIST) |
Authorized Official Contact | 2056957171 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Larry J Whisenant Pc 121 10th St Nw Pob 448 Vernon AL 35592-5843 Ph: (205) 695-7171 | Larry J Whisenant Pc 121 10th St Nw Vernon AL 35592 Ph: (205) 695-7171 |
NPI Number | 1396812186 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 09/17/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396812186 | NPI | - | NPPES |
529921320 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 3713 (Alabama) | Primary |