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Individual

DANIEL WHITESITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
14596 ID-41, RATHDRUM, ID 83858
(208) 687-4455
Mailing address
3009 N CHARLEVILLE RD APT 227, POST FALLS, ID 83854-7870

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5039
ID

Other

Enumeration date
06/05/2019
Last updated
06/05/2019
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