Individual
JOSEPH S. WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
196 S MCCLEARY RD, EXCELSIOR SPRINGS, MO 64024-8456
(816) 630-5713
(641) 226-5759
Mailing address
196 S MCCLEARY RD, EXCELSIOR SPRINGS, MO 64024-8456
(816) 630-5713
(641) 226-5759
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2012021223
MO
1223G0001X
General Practice Dentistry
09164
IA
1223G0001X
General Practice Dentistry
Primary
2012021223
MO
Other
Enumeration date
06/29/2012
Last updated
12/21/2020
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