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General NPI Number Information
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NPI Number | 1043958903
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Entity Type | Organization
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Legal Business Name | JAMIE WHITE ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 05/21/2022
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Last Update Date | 05/21/2022
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Provider Practice Location Address
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Address Line | 1202 N DIVISION AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-5041
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Country | US
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Telephone | 208-265-8018
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Fax |
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Provider Business Mailing Address
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Address Line | 217 CEDAR ST # 43
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City | SANDPOINT
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State | ID
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Zip | 83864-1410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMIE WHITE
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Credential | DMD, MS, DHSC
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Telephone | 520-390-1982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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