# DR. C.R. WHITE AND ASSOCIATES DENTAL CENTER,INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Clarice R. White
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235448598
- **Authorized official:** DR. CLARICE R WHITE DDS (OWNER/PRESIDENT)
- **Authorized official phone:** (901) 294-2634

## Contact information

- **Practice address:** 12173 MAIN ST STE B, MASON, TN 38049-7054
- **Practice address phone:** (901) 294-2634
- **Practice address fax:** (901) 294-2639
- **Mailing address:** PO BOX 310, STANTON, TN 38069-0310
- **Mailing address phone:** (901) 294-2634
- **Mailing address fax:** (901) 294-2639

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5088 | TN | Yes |

## Other

- **Enumeration date:** 10/04/2010
- **Last updated:** 10/04/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3225536 | — | TN |