Individual
KENNETH B WHITWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
41619 MARGARITA RD STE 102, TEMECULA, CA 92591-2986
(951) 676-4473
Mailing address
45485 EAGLE CREST LN, TEMECULA, CA 92592-1843
(951) 694-6667
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
D42784
CA
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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