Individual
DR. LARRY JOE WHISENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
121 10TH ST NW, VERNON, AL 35592
(205) 695-7171
(205) 695-0801
Mailing address
POB 448, 121 10TH ST NW, VERNON, AL 35592
(205) 695-7171
(205) 695-0801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AL3713
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008208040
—
AL
01
—
51097482
BCBS OF AL
AL
Enumeration date
11/02/2006
Last updated
06/18/2008
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