# TODD WHITLOCK, DDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881843613
- **Authorized official:** DR. TODD MITCHELL WHITLOCK D.D.S. (PRESIDENT)
- **Authorized official phone:** (812) 332-0052

## Contact information

- **Practice address:** 3671 S SARE RD, BLOOMINGTON, IN 47401-4173
- **Practice address phone:** (812) 332-0052
- **Practice address fax:** (812) 332-0128
- **Mailing address:** 3671 S SARE RD, BLOOMINGTON, IN 47401-4173
- **Mailing address phone:** (812) 332-0052
- **Mailing address fax:** (812) 332-0128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009170 | IN | Yes |

## Other

- **Enumeration date:** 09/17/2008
- **Last updated:** 02/17/2012