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NPI Code Detail

MEDICARE: DR. BERNARD B. WHITE D.D.S.

MEDICARE:  DR. BERNARD B. WHITE  D.D.S.
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry19186CA

General Provider Information

NPI Number : 1700926870
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERNARD B. WHITE D.D.S.
Provider Business Mailing Address
First Line : 8121 VAN NUYS BLVD
Second Line : SUITE 514
City : PANORAMA CITY
State : CA
Zip : 91402-5105
Country : US
Telephone Number : 818-780-0310
Fax Number : 818-780-4582
Provider Business Practice Location Address
First Line : 8121 VAN NUYS BLVD
Second Line : SUITE 514
City : PANORAMA CITY
State : CA
Zip : 91402-5105
Country : US
Telephone Number : 818-780-0310
Fax Number : 818-780-4582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ DR. BERNARD B. WHITE D.D.S.” Practice Location

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