Provider Demographics
NPI:1417005299
Name:WHITE, JOHN CRAIG (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CRAIG
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9365 OLDE 8 RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2052
Mailing Address - Country:US
Mailing Address - Phone:330-468-0607
Mailing Address - Fax:330-468-1329
Practice Address - Street 1:9365 OLDE 8 RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2052
Practice Address - Country:US
Practice Address - Phone:330-468-0607
Practice Address - Fax:330-468-1329
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0187381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics