MEDICARE: NATHAN O WHITE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	9174	NC

General Provider Information

NPI Number	:	1194011965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN O WHITE DDS

Provider Business Mailing Address
First Line	:	501 EASTOWNE DR
Second Line	:	STE 150
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-6224
Country	:	US
Telephone Number	:	919-251-9313
Fax Number	:	919-251-9316

Provider Business Practice Location Address
First Line	:	501 EASTOWNE DR
Second Line	:	STE 150
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-6224
Country	:	US
Telephone Number	:	919-251-9313
Fax Number	:	919-251-9316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	10/31/2016

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