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NPI Code Detail

MEDICARE: DR. JOHN MARSHALL WHITE JR. DMD

MEDICARE: DR. JOHN MARSHALL WHITE JR. DMD
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
11223G0001XGeneral Practice Dentistry19395OH

General Provider Information

NPI Number : 1578682019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MARSHALL WHITE JR. DMD
Provider Business Mailing Address
First Line : 78 MESSIMER DR
Second Line :
City : NEWARK
State : OH
Zip : 43055-3627
Country : US
Telephone Number : 740-344-1200
Fax Number : 740-344-6566
Provider Business Practice Location Address
First Line : 78 MESSIMER DR
Second Line :
City : NEWARK
State : OH
Zip : 43055-3627
Country : US
Telephone Number : 740-344-1200
Fax Number : 740-344-6566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 01/13/2012

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