Provider Demographics
NPI:1437671567
Name:WHETTEN, AUSTIN ARGYLE (DMD)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:ARGYLE
Last Name:WHETTEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6462 NEW MEXICO HIGHWAY 104
Mailing Address - Street 2:
Mailing Address - City:NEWKIRK
Mailing Address - State:NM
Mailing Address - Zip Code:88431-9704
Mailing Address - Country:US
Mailing Address - Phone:505-603-6113
Mailing Address - Fax:
Practice Address - Street 1:6017 HILLSIDE RD STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-7210
Practice Address - Country:US
Practice Address - Phone:505-603-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice