Organization
LARRY J WHISENANT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY JOE WHISENANT DMD (OWNER DENTIST)
(205) 695-7171
Entity
Organization
Contact information
Practice address
121 10TH ST NW, VERNON, AL 35592
(205) 695-7171
(205) 695-0801
Mailing address
121 10TH ST NW, POB 448, VERNON, AL 35592-5843
(205) 695-7171
(205) 695-0801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3713
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529921320
—
AL
Enumeration date
11/29/2006
Last updated
09/17/2009
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