Individual
DR. JOHN B WHITLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
541 SHADOWS LN, SUITE A, BATON ROUGE, LA 70806-6531
(225) 924-4383
(225) 924-4364
Mailing address
541 SHADOWS LN, SUITE A, BATON ROUGE, LA 70806-6531
(225) 924-4383
(225) 924-4364
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3902
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1839027
—
LA
Enumeration date
03/06/2007
Last updated
07/08/2007
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