Individual
DR. CODY JAMES WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
130 S RAPP AVE, COLUMBIA, IL 62236-2352
(616) 281-7300
Mailing address
536 S MAIN ST, WATERLOO, IL 62298-1444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.030680
IL
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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