Individual ProviderDaniel WhitleyDentistDental ProvidersPractice Address200 Doctors Dr, Jacksonville, NC 28546-6310(910) 353-4242(919) 457-6489PECOS EnrollmentBased on the most recent information from CMS, provider Daniel Whitley 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 yesterday at 11:51 AM.Profile DetailsProvider ID1184039455Provider TypeIndividualFull NameWhitley, DanielTitleDr.CredentialDDSGenderMaleSole ProprietorNoEnumeration Date6/25/2014Last Updated8/8/2016Contact InformationPractice LocationPractice Address200 Doctors Dr, Jacksonville, NC 28546-6310Phone(910) 353-4242FaxUnlisted FaxMailing LocationMailing Address311 Pineland Dr, Goldsboro, NC 27534-1717Phone(919) 457-6489FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense9763North Carolina