Healthcare Provider Details

I. General information

NPI: 1285787051
Provider Name (Legal Business Name): WHITE, GREER AND MAGGARD, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 BEAUMONT CENTRE CIR SUITE 200
LEXINGTON KY
40513-1934
US

IV. Provider business mailing address

3141 BEAUMONT CENTRE CIR SUITE 200
LEXINGTON KY
40513-1934
US

V. Phone/Fax

Practice location:
  • Phone: 859-296-4846
  • Fax: 859-296-2842
Mailing address:
  • Phone: 859-296-4846
  • Fax: 859-296-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6263
License Number StateKY

VIII. Authorized Official

Name: DR. J. GREG WHITE
Title or Position: PARTNER
Credential: D.M.D.
Phone: 859-296-4846