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Individual

DR. SAMUEL EDWARD WHISENANT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.D. D.P.D.

Contact information

Practice address
25052 104TH AVE SE, SUITE G, KENT, WA 98030-6853
(253) 813-8000
(253) 813-8007
Mailing address
25052 104TH AVE SE, SUITE G, KENT, WA 98030-6853
(253) 813-8000
(253) 813-8007

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000381
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5047857
PROVIDER
WA
Enumeration date
04/18/2007
Last updated
07/08/2007
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