Provider Demographics
NPI:1225129034
Name:WHITED, TOMMY NEIL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:NEIL
Last Name:WHITED
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:940 COLLIERVILLE ARLINGTON RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-8100
Mailing Address - Country:US
Mailing Address - Phone:901-850-1118
Mailing Address - Fax:901-850-1157
Practice Address - Street 1:940 COLLIERVILLE ARLINGTON RD
Practice Address - Street 2:SUITE 109
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-8100
Practice Address - Country:US
Practice Address - Phone:901-850-1118
Practice Address - Fax:901-850-1157
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNDS46591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics