Provider Demographics
NPI:1659188902
Name:WHITNEY FAMILY DENTISTRY
Entity type:Organization
Organization Name:WHITNEY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CADE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-694-3114
Mailing Address - Street 1:305 S BOSQUE ST STE A
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-2737
Mailing Address - Country:US
Mailing Address - Phone:254-694-3114
Mailing Address - Fax:
Practice Address - Street 1:305 S BOSQUE ST STE A
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2737
Practice Address - Country:US
Practice Address - Phone:254-694-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty