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General NPI Number Information
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NPI Number | 1154764793
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Entity Type | Individual
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Provider Name | GREGORY DANIEL WHITE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2013
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 6599 MAIN ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5820
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Country | US
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Telephone | 716-333-7873
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Fax |
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Provider Business Mailing Address
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Address Line | 80 ROLLINGWOOD ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-1834
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Country | US
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Telephone | 716-903-3274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 059138
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License Number State | NY
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