Organization
BRENT WHITTAKER DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT WHITTAKER DDS (OWNER)
(614) 725-7816
Entity
Organization
Contact information
Practice address
1677 MARION MOUNT GILEAD RD STE 300, MARION, OH 43302-5913
(614) 725-7816
Mailing address
1677 MARION MOUNT GILEAD RD STE 300, MARION, OH 43302-5913
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356901714
NPI
OH
Enumeration date
07/21/2022
Last updated
07/21/2022
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