Individual
MICHAEL J WHITEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3020 MAPLEWOOD AVENUE, WINSTON-SALEM, NC 27103-4012
(336) 768-9881
(336) 768-6066
Mailing address
125 CENTURY OAKS, WINSTON-SALEM, NC 27106
(336) 922-9577
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990129
—
NC
Enumeration date
07/20/2006
Last updated
07/08/2007
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