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General NPI Number Information
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NPI Number | 1407400633
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Entity Type | Individual
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Provider Name | KATELYN MARIE WHITE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 911 N ELM ST STE 230
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City | HINSDALE
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State | IL
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Zip | 60521-3684
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Country | US
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Telephone | 630-323-4468
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Fax |
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Provider Business Mailing Address
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Address Line | 628 YOSEMITE AVE APT 202
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City | NAPERVILLE
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State | IL
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Zip | 60563-8846
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Country | US
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Telephone | 270-792-2957
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019032271
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License Number State | IL
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