Individual
DR. JERRY DAVID WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1125 E 17TH ST, TRENTON, MO 64683-1929
(660) 359-2005
(660) 359-2461
Mailing address
1125 E 17TH ST, TRENTON, MO 64683-1929
(660) 359-2005
(660) 359-2461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015619
MO
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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