Provider Demographics
NPI:1891241360
Name:THE WHOLE TOOTH
Entity Type:Organization
Organization Name:THE WHOLE TOOTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:BARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-388-9265
Mailing Address - Street 1:1000 TOWNE CENTER BLVD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4052
Mailing Address - Country:US
Mailing Address - Phone:912-388-9265
Mailing Address - Fax:
Practice Address - Street 1:1000 TOWNE CENTER BLVD
Practice Address - Street 2:SUITE 505
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4052
Practice Address - Country:US
Practice Address - Phone:912-388-9265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty