Whittaker, Jack Allen

Whittaker, Jack Allen is an individual health care provider with primary practice located at 960 W Wooster St Ste. 201, Bowling Green OH 43402-2644. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Whittaker, Jack Allen can be contacted via phone (419) 352-3527.

Contact Information

Primary practice address
960 W Wooster St Ste. 201 Bowling Green OH 43402-2644
Phone: (419) 352-3527
Fax: (419) 352-6122
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X OH 12369 Ohio

Profile Details

NPI number 1558356030
LBN Legal business name Whittaker, Jack Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558356030 NPPES
Ohio MEDICAID 0017332

Popular Providers