Provider Demographics
NPI:1831326420
Name:WHITE, SARA JO WILLINGHAM (DDS)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:JO WILLINGHAM
Last Name:WHITE
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:400 GALLERIA PKWY SE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5980
Mailing Address - Country:US
Mailing Address - Phone:678-904-5665
Mailing Address - Fax:678-904-5666
Practice Address - Street 1:1800 FORT HARRISON RD
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-1413
Practice Address - Country:US
Practice Address - Phone:219-923-3886
Practice Address - Fax:219-923-6283
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2009-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN12011320A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice