Provider Demographics
NPI:1528409331
Name:WHITE, GEORGE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:E
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3200 S UNIVERISTY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33328
Mailing Address - Country:UM
Mailing Address - Phone:954-262-7394
Mailing Address - Fax:
Practice Address - Street 1:3200 S UNIVERISTY DRIVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:UM
Practice Address - Phone:954-262-7394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry