Provider Demographics
NPI:1407630882
Name:WHITE PEARL DENTISTRY LLC
Entity Type:Organization
Organization Name:WHITE PEARL DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMOUDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-222-0055
Mailing Address - Street 1:203 S ZEEB RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8325
Mailing Address - Country:US
Mailing Address - Phone:734-222-0555
Mailing Address - Fax:734-222-0050
Practice Address - Street 1:203 S ZEEB RD STE 201
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8325
Practice Address - Country:US
Practice Address - Phone:734-222-0555
Practice Address - Fax:734-222-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty