| Whitlock Family Dentistry | |
|
514g E Woodrow Wilson Ave Jackson MS 39216-4538 | |
| (601) 982-7636 | |
| (601) 982-4536 |
| Full Name | Whitlock Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 514g E Woodrow Wilson Ave, Jackson, Mississippi |
| Authorized Official Name and Position | Patricia R Whitlock (BOOKKEEPER) |
| Authorized Official Contact | 6019827636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitlock Family Dentistry 514 G East Woodrow Wilson Jackson MS 39216-4538 Ph: (601) 982-7636 | Whitlock Family Dentistry 514g E Woodrow Wilson Ave Jackson MS 39216-4538 Ph: (601) 982-7636 |
| NPI Number | 1356537948 |
|---|---|
| Provider Enumeration Date | 09/18/2007 |
| Last Update Date | 09/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356537948 | NPI | - | NPPES |
| 07631537 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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