Provider Demographics
NPI:1922667427
Name:WINDMILL DENTAL
Entity Type:Organization
Organization Name:WINDMILL DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHETTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:505-603-6113
Mailing Address - Street 1:2726 STONECREST DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3449
Mailing Address - Country:US
Mailing Address - Phone:505-603-6113
Mailing Address - Fax:
Practice Address - Street 1:6017 HILLSIDE RD STE 100
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-7218
Practice Address - Country:US
Practice Address - Phone:505-603-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental