MEDICARE: DR. DON MICHAEL WHITTEN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2097	AR

General Provider Information

NPI Number	:	1134295553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DON MICHAEL WHITTEN D.M.D.

Provider Business Mailing Address
First Line	:	7400 N HILLS BLVD
Second Line	:
City	:	SHERWOOD
State	:	AR
Zip	:	72116-4539
Country	:	US
Telephone Number	:	501-835-4567
Fax Number	:	501-834-9178

Provider Business Practice Location Address
First Line	:	7400 N HILLS BLVD
Second Line	:
City	:	SHERWOOD
State	:	AR
Zip	:	72116-4539
Country	:	US
Telephone Number	:	501-835-4567
Fax Number	:	501-834-9178

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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