Provider Demographics
NPI:1861452773
Name:WHITE, NICHOLAS A (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:A
Last Name:WHITE
Suffix:
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 1:746 STIRLING CENTER PL
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4893
Mailing Address - Country:US
Mailing Address - Phone:407-942-0225
Mailing Address - Fax:
Practice Address - Street 1:746 STIRLING CENTER PL
Practice Address - Street 2:SUITE 1100
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4893
Practice Address - Country:US
Practice Address - Phone:407-942-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry