Provider Demographics
NPI:1750415931
Name:WIGNALL, WHITNEY (DMD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:
Last Name:WIGNALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FUNDY RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1705
Mailing Address - Country:US
Mailing Address - Phone:207-781-2272
Mailing Address - Fax:207-781-3605
Practice Address - Street 1:6 FUNDY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1705
Practice Address - Country:US
Practice Address - Phone:207-781-2272
Practice Address - Fax:207-781-3605
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME37671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry