DR. Samuel Edward Whisenant JR., L.D. D.P.D.

NPI #1679799449 in Kent, Washington

Provider Information

NPI Number: 1679799449
Entity Type: Individual
Name: DR. Samuel Edward Whisenant JR., L.D. D.P.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Denturist
Credential: L.D. D.P.D.
Enumeration Date: Apr 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 25052 104TH AVE SE
Address 2: SUITE G
City: Kent
State: Washington
ZIP Code: 98030-6853
Phone: (253) 813-8000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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