| Doctor Name: | DR. SAMUEL EDWARD WHISENANT |
| NPI Number: | 1679799449 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.D. D.P.D. |
| License Number: | DN00000381 |
| Business Practice Address: | 25052 104th Ave Se Suite G Kent, WA - 980306853 |
| Business Phone Number: | 2538138000 |
| Business Fax Number: | 2538138007 |
| Mailing Address: | 25052 104th Ave Se, Suite G KENT |
| State: | WA |
| Postal Code: | 980306853 |
| Phone Number: | 2538138000 |
| Fax Number: | 2538138007 |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | DN00000381 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |