Individual
ANITA WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
508 NORTH MINNESOTA STREET, WARREN, MN 56762-0093
(218) 281-3441
(218) 281-6966
Mailing address
620 SUMMIT AVENUE, CROOKSTON, MN 56716-2799
(218) 281-3441
(218) 281-6966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8197
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
531018100
—
MN
Enumeration date
01/17/2008
Last updated
02/19/2009
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