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Individual

MR. DALE R WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
420 CENTER AVE, MOORHEAD DRUG CO, MOORHEAD, MN 56560
(218) 233-1529
(218) 233-8917
Mailing address
1910 6TH ST S, MOORHEAD, MN 56560
(218) 233-6485

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113896
MN
183500000X
Pharmacist
3764
ND

Other

Enumeration date
03/09/2007
Last updated
07/08/2007
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