Individual
JOHN G WHITAKER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
906 ORANGE ST, FORT VALLEY, GA 31030-3456
(478) 825-2001
(478) 825-7836
Mailing address
PO BOX 1193, FORT VALLEY, GA 31030-1193
(478) 825-2001
(478) 825-7836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014785
GA
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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