Daniel Francis Woodlock, DDS
Individual provider Active NPI General Practice Dentistry · White Hall, IL
NPI 1922142124 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922142124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 415 N Main St
White Hall, IL 62092-1148 - Phone
- (217) 374-6132
- Fax
- (217) 374-6220
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019017371 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
415 N Main St
White Hall, IL 62092-1148
Mailing address
415 N Main St
White Hall, IL 62092-1148
Phone (217) 374-6132
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004249 | Medicaid | IL |
Other providers in White Hall, IL
- North Green Unit School Dist 3
- Pamida Stores Operating Co LLC
- Pharmacy Plus, Inc.
- Susan Randall
- White Hall Nursing and Rehabilitation Center, LLC
All providers in White Hall, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.