Individual
CLINTON HARLAN WHITTINGTON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4856 MAIN ST, FLORA, MS 39071-1701
(601) 879-8099
Mailing address
PO BOX O, FLORA, MS 39071-1701
(601) 879-8099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
168775
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064355
—
MS
Enumeration date
08/30/2006
Last updated
07/08/2007
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