Provider Demographics
NPI:1316037799
Name:WHITE, HALLEY R (DDS MPH)
Entity Type:Individual
Prefix:DR
First Name:HALLEY
Middle Name:R
Last Name:WHITE
Suffix:
Gender:F
Credentials:DDS MPH
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Mailing Address - Street 1:8115 MARKET ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8427
Mailing Address - Country:US
Mailing Address - Phone:910-686-1869
Mailing Address - Fax:910-319-6014
Practice Address - Street 1:8115 MARKET ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8427
Practice Address - Country:US
Practice Address - Phone:910-686-1869
Practice Address - Fax:910-319-6014
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC76671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9028 NOtherBCBS