Provider Demographics
NPI:1265031793
Name:AN WHITE, DDS, PLLC
Entity Type:Organization
Organization Name:AN WHITE, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-930-7847
Mailing Address - Street 1:3607 S MAIN ST # 107
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5406
Mailing Address - Country:US
Mailing Address - Phone:832-930-7847
Mailing Address - Fax:
Practice Address - Street 1:3607 S MAIN ST # 107
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5406
Practice Address - Country:US
Practice Address - Phone:832-930-7847
Practice Address - Fax:281-969-8032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty