Provider Demographics
NPI:1346679503
Name:WHITE SMILES FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WHITE SMILES FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE PERSON
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-473-7723
Mailing Address - Street 1:206 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04742-1121
Mailing Address - Country:US
Mailing Address - Phone:207-473-7723
Mailing Address - Fax:207-473-7287
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04742-1121
Practice Address - Country:US
Practice Address - Phone:207-473-7723
Practice Address - Fax:207-473-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty