Individual
DR. DOUGLAS G WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2120 N 850 W, SHIPSHEWANA, IN 46565
(260) 768-4180
(260) 768-9192
Mailing address
PO BOX 848, SHIPSHEWANA, IN 46565-0848
(260) 768-4180
(260) 768-9192
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009055
IN
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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