Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 8928 | SC |
NPI | 1689104671 |
---|---|
Provider Name | Dr. Alex Whittington |
First Address | Sumter, SC 29150-2984 |
Second Address | Sumter, SC 29150-4748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 09/09/2019 |