Provider Demographics
NPI:1932883485
Name:WHITE, STEWART (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:
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 1:7980 SALLY CT
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5440
Mailing Address - Country:US
Mailing Address - Phone:281-883-6644
Mailing Address - Fax:
Practice Address - Street 1:1034 N WILLIS ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-4622
Practice Address - Country:US
Practice Address - Phone:325-673-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist