Provider Demographics
NPI:1508355330
Name:WHITTEMORE, BREANNA GARMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BREANNA
Middle Name:GARMAN
Last Name:WHITTEMORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8603
Mailing Address - Country:US
Mailing Address - Phone:740-775-8050
Mailing Address - Fax:
Practice Address - Street 1:11 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8603
Practice Address - Country:US
Practice Address - Phone:740-775-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist