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General NPI Number Information
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NPI Number | 1477767150
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Entity Type | Organization
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Legal Business Name | ODIE A. WHITLOW, D.D.S.
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 7063 MESSER RD
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City | RICHMOND
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State | VA
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Zip | 23231-5509
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Country | US
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Telephone | 804-222-3310
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Fax | 804-222-6973
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Provider Business Mailing Address
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Address Line | 7063 MESSER RD
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City | RICHMOND
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State | VA
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Zip | 23231-5509
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Country | US
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Telephone | 804-222-3310
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Fax | 804-222-6973
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ODIE A. WHITLOW JR.
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Credential | D.D.S.
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Telephone | 804-222-3310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401004181
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License Number State | VA
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