| Larry J Whisenant Pc | |
|
121 10th St Nw Vernon AL 35592 | |
| (205) 695-7171 | |
| (205) 695-0801 |
| Full Name | Larry J Whisenant Pc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |