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General NPI Number Information
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NPI Number | 1407003957
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Entity Type | Organization
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Legal Business Name | WHITE DENTAL CARE
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 2802 8TH ST
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City | WOODWARD
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State | OK
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Zip | 73801-6722
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Country | US
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Telephone | 580-256-4301
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Fax | 580-256-1437
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Provider Business Mailing Address
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Address Line | 2802 8TH ST
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City | WOODWARD
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State | OK
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Zip | 73801-6722
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Country | US
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Telephone | 580-256-4301
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Fax | 580-256-1437
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MORI KENT WHITE
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Credential | D.D.S.
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Telephone | 580-256-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5133
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5574
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5088
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License Number State | OK
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