Provider Demographics
NPI:1023202942
Name:WHITE, TERRYL A (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TERRYL
Middle Name:A
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 PIDGEON HILL DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6154
Mailing Address - Country:US
Mailing Address - Phone:703-444-5337
Mailing Address - Fax:703-444-5337
Practice Address - Street 1:20 PIDGEON HILL DR
Practice Address - Street 2:SUITE 207
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6154
Practice Address - Country:US
Practice Address - Phone:703-444-5337
Practice Address - Fax:703-444-5337
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04010067501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics