Provider Demographics
NPI:1720362296
Name:LONDON-WHITE AND MAGGARD, PSC
Entity Type:Organization
Organization Name:LONDON-WHITE AND MAGGARD, PSC
Other - Org Name:WHITE AND MAGGARD ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-296-4846
Mailing Address - Street 1:200 CITY HILL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-3038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CITY HILL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-3038
Practice Address - Country:US
Practice Address - Phone:606-877-1900
Practice Address - Fax:606-877-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY62631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty