Healthcare Provider Details

I. General information

NPI: 1063822799
Provider Name (Legal Business Name): DAVID CURTIS WHITE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 2ND ST S
NAMPA ID
83651-3837
US

IV. Provider business mailing address

7664 E LAFAYETTE ST
NAMPA ID
83687-4506
US

V. Phone/Fax

Practice location:
  • Phone: 208-466-2456
  • Fax:
Mailing address:
  • Phone: 801-919-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD-5394
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: