Individual
BENJAMIN WHITTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1400 FOUNTAIN WAY, MOLALLA, OR 97038-8874
(503) 759-3333
(503) 759-3291
Mailing address
1400 FOUNTAIN WAY, MOLALLA, OR 97038-8874
(503) 759-3333
(503) 759-3291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6468
NV
Other
Enumeration date
08/14/2014
Last updated
11/14/2019
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