# DIANA J WHITTAKER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265180723
- **Authorized official:** DR. DIANA WHITTAKER DDS (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (209) 380-5486

## Contact information

- **Practice address:** 584 S MAIN ST, PLYMOUTH, MI 48170-1709
- **Practice address phone:** (734) 453-5588
- **Mailing address:** 584 S MAIN ST, PLYMOUTH, MI 48170-1709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 03/14/2022