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Individual

DR. STEVEN BRYAN WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2926 W HUNTSVILLE AVE, SPRINGDALE, AR 72762-7726
(479) 717-1047
(866) 756-3200
Mailing address
432 N WILLOW AVE, FAYETTEVILLE, AR 72701-4349
(479) 263-1951

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
18
AR
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
2
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3249
STATE LICENSE
AR
Enumeration date
02/08/2006
Last updated
10/02/2014
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