Provider Demographics
NPI:1831913797
Name:WHITE MAPLE DENTAL PLLC
Entity type:Organization
Organization Name:WHITE MAPLE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF WHITE MAPLE DENTAL PLL
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEXINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-393-9388
Mailing Address - Street 1:460 RANSOM RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9635
Mailing Address - Country:US
Mailing Address - Phone:716-393-9388
Mailing Address - Fax:
Practice Address - Street 1:460 RANSOM RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-9635
Practice Address - Country:US
Practice Address - Phone:716-393-9388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental