Provider Demographics
NPI:1346332160
Name:WHITE, WILLIAM (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
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 1:400 W CLARKSTON RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-4101
Mailing Address - Country:US
Mailing Address - Phone:248-693-4422
Mailing Address - Fax:248-693-6950
Practice Address - Street 1:400 W CLARKSTON RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-4101
Practice Address - Country:US
Practice Address - Phone:248-693-4422
Practice Address - Fax:248-693-6950
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist