OrganizationDaniel Whitley Iii Dds, PaDentistDental ProvidersPractice Address200 Doctors Dr Ste F, Jacksonville, NC 28546-6308(910) 353-4242PECOS EnrollmentBased on the most recent information from CMS, provider Daniel Whitley Iii Dds, Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1134639404Provider TypeOrganizationFull NameDaniel Whitley Iii Dds, PaSubpartNoEnumeration Date10/2/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address200 Doctors Dr Ste F, Jacksonville, NC 28546-6308Phone(910) 353-4242Fax(910) 577-6421Mailing LocationMailing Address200 Doctors Dr Ste F, Jacksonville, NC 28546-6308Phone(910) 353-4242Fax(910) 577-6421Authorized OfficialNameWhitley, Daniel (President)Phone(910) 353-4242Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer