Individual
DR. DANIEL LEE WHITED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12131 ELM CREEK BLVD N, MAPLE GROVE, MN 55369-7093
(763) 416-1983
Mailing address
7114 WHITEHALL RD, SHAKOPEE, MN 55379-8084
(952) 233-3730
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2651
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
833724100
—
MN
Enumeration date
01/16/2007
Last updated
12/02/2016
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