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General NPI Number Information
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NPI Number | 1962714147
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Entity Type | Individual
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Provider Name | DANIEL W. WHITE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2010
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 914 E SHOTWELL ST
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City | BAINBRIDGE
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State | GA
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Zip | 39819-4148
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Country | US
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Telephone | 229-246-8681
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Fax | 220-246-6448
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Provider Business Mailing Address
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Address Line | 914 E SHOTWELL ST
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City | BAINBRIDGE
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State | GA
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Zip | 39819-4148
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Country | US
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Telephone | 229-246-8681
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Fax | 220-246-6448
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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 | DN014093
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License Number State | GA
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