Provider Demographics
NPI:1972580728
Name:WHITLOW, ODIE ALLEN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ODIE
Middle Name:ALLEN
Last Name:WHITLOW
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7063 MESSER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-5509
Mailing Address - Country:US
Mailing Address - Phone:804-222-3310
Mailing Address - Fax:804-222-6973
Practice Address - Street 1:7063 MESSER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-5509
Practice Address - Country:US
Practice Address - Phone:804-222-3310
Practice Address - Fax:804-222-6973
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010041811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice