Provider Demographics
NPI:1154475150
Name:WHITE, DAVID ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLAN
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:208 HALEY RD
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78636-0421
Mailing Address - Country:US
Mailing Address - Phone:830-868-7344
Mailing Address - Fax:830-868-4606
Practice Address - Street 1:208 HALEY RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TX
Practice Address - Zip Code:78636-0421
Practice Address - Country:US
Practice Address - Phone:830-868-7344
Practice Address - Fax:830-868-4606
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10089122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist