Provider Demographics
NPI:1447232954
Name:WHITTAKER, EARL L (DDS)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:L
Last Name:WHITTAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N POST ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2507
Mailing Address - Country:US
Mailing Address - Phone:509-326-7307
Mailing Address - Fax:
Practice Address - Street 1:1212 N POST ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2507
Practice Address - Country:US
Practice Address - Phone:509-326-7307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA57711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice