Provider Demographics
NPI:1578682019
Name:WHITE, JOHN MARSHALL JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARSHALL
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 MESSIMER DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3627
Mailing Address - Country:US
Mailing Address - Phone:740-344-1200
Mailing Address - Fax:740-344-6566
Practice Address - Street 1:78 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3627
Practice Address - Country:US
Practice Address - Phone:740-344-1200
Practice Address - Fax:740-344-6566
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH193951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice