Provider Demographics
NPI:1528831617
Name:WHETSTINE, LAURA JEAN (RDH)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:WHETSTINE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:PICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:KS
Mailing Address - Zip Code:66087-5289
Mailing Address - Country:US
Mailing Address - Phone:816-344-8838
Mailing Address - Fax:
Practice Address - Street 1:3349B THRASHER RD
Practice Address - Street 2:
Practice Address - City:WHITE CLOUD
Practice Address - State:KS
Practice Address - Zip Code:66094-4005
Practice Address - Country:US
Practice Address - Phone:785-595-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12353124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist