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Organization

WHITESIDES ORTHODONTICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH M WHITESIDES DDS , MS (MANAGING MEMBER)
(941) 627-2011
Entity
Organization

Contact information

Practice address
2286 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-3924
(941) 627-2011
(941) 627-6716
Mailing address
2286 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-3924
(941) 627-2011
(941) 627-6716

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN18814
FL

Other

Enumeration date
04/23/2012
Last updated
04/23/2012
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