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General NPI Number Information
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NPI Number | 1326232737
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Entity Type | Organization
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Legal Business Name | DR. JOHN R. WHELESS III, DDS
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 311 BROWN ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3801
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Country | US
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Telephone | 276-632-3151
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Fax | 276-632-6456
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Provider Business Mailing Address
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Address Line | 311 BROWN ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3801
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Country | US
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Telephone | 276-632-3151
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Fax | 276-632-6456
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SANDRA B WHELESS
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Credential |
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Telephone | 276-632-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | VA
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