Provider Demographics
NPI:1568665487
Name:W. SCOTT WHITE D.D.S. P.C.
Entity Type:Organization
Organization Name:W. SCOTT WHITE D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-291-6000
Mailing Address - Street 1:301 E 141ST ST
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-3537
Mailing Address - Country:US
Mailing Address - Phone:918-291-6000
Mailing Address - Fax:918-291-2095
Practice Address - Street 1:301 E 141ST ST
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-3537
Practice Address - Country:US
Practice Address - Phone:918-291-6000
Practice Address - Fax:918-291-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty