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General NPI Number Information
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NPI Number | 1689092033
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Entity Type | Organization
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Legal Business Name | ASHEVILLE FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 1011 TUNNEL RD SUITE 140
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City | ASHEVILLE
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State | NC
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Zip | 28805-2058
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Country | US
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Telephone | 828-299-4455
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Fax | 828-299-0550
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Provider Business Mailing Address
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Address Line | 1011 TUNNEL RD SUITE 140
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City | ASHEVILLE
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State | NC
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Zip | 28805-2058
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Country | US
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Telephone | 828-299-4455
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Fax | 828-299-0550
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Authorized Official
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Title or Position | DENTIST
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Name | MR. CALLAN D WHITE
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Credential | DDS
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Telephone | 828-299-4455
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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 | 8622
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8614
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License Number State | NC
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