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General NPI Number Information
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NPI Number | 1992233845
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Entity Type | Individual
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Provider Name | NATHAN BRANDON WHITE DMD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 2415 CENTRAL PKWY
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City | MONTGOMERY
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State | AL
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Zip | 36106-3140
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Country | US
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Telephone | 334-277-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 2ND AVE S APT 522
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2088
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Country | US
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Telephone | 205-936-1621
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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 | PENDING
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License Number State | AL
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