Provider Demographics
NPI:1033564992
Name:WILLIAM B. WHITTEMORE, D.M.D., L.L.C.
Entity Type:Organization
Organization Name:WILLIAM B. WHITTEMORE, D.M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHITTEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-803-2357
Mailing Address - Street 1:2541 BEACON HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3689
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8036 SE 13TH AVE STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6606
Practice Address - Country:US
Practice Address - Phone:503-803-2357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty