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General NPI Number Information
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NPI Number | 1144759275
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Entity Type | Organization
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Legal Business Name | WHITE SMILES FAMILY DENTISTRY
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 594 E 800 S SUITE G
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City | OREM
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State | UT
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Zip | 84097
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Country | US
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Telephone | 801-765-1443
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Fax | 801-722-0045
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Provider Business Mailing Address
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Address Line | 594 E 800 S STE G
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City | OREM
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State | UT
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Zip | 84097-6303
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Country | US
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Telephone | 801-765-1443
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Fax | 801-722-0045
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. JEREMY J WHITE
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Credential | DDS
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Telephone | 801-765-1443
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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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