Provider Demographics
NPI:1588781900
Name:WILHOITE, STEPHEN ELLIOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ELLIOTT
Last Name:WILHOITE
Suffix:
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 1:4401 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3193
Mailing Address - Country:US
Mailing Address - Phone:770-587-2541
Mailing Address - Fax:770-587-9652
Practice Address - Street 1:4401 SHALLOWFORD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3193
Practice Address - Country:US
Practice Address - Phone:770-587-2541
Practice Address - Fax:770-587-9652
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice