Individual
DR. DOUGLAS LEEROY WHITTET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1122 N LIBERTY ST, BOISE, ID 83704-8741
(208) 947-6821
Mailing address
1122 N LIBERTY ST, BOISE, ID 83704-8741
(208) 947-6821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
CS8544
ID
122300000X
Dentist
D6003
OR
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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