MEDICARE: DR. KEVIN C. 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	1223G0001X	General Practice Dentistry	4269	AL

General Provider Information

NPI Number	:	1336251800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN C. WHITE DDS

Provider Business Mailing Address
First Line	:	1900 CRESTWOOD BLVD
Second Line	:	STE 211
City	:	IRONDALE
State	:	AL
Zip	:	35210
Country	:	US
Telephone Number	:	205-271-6851
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 SPRING HILL AVE
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36604-3206
Country	:	US
Telephone Number	:	251-586-0130
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. KEVIN C. WHITE DDS” Practice Location

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