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General NPI Number Information
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NPI Number | 1578847620
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Entity Type | Organization
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Legal Business Name | DANIEL WHITEMARSH DMD, P.S., INC.
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 311 E 1ST ST
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City | CLE ELUM
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State | WA
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Zip | 98922-1201
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Country | US
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Telephone | 509-674-2307
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Fax | 509-674-7330
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Provider Business Mailing Address
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Address Line | 311 E 1ST ST
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City | CLE ELUM
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State | WA
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Zip | 98922-1201
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Country | US
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Telephone | 509-674-2307
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Fax | 509-674-7330
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL KEITH WHITEMARSH
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Credential | D.M.D.
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Telephone | 509-374-7245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 60006068
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License Number State | WA
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