# WHITE FAMILY DENTAL - MASONIC VILLAGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** White Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265361638
- **Authorized official:** CASEY CASTLE (DIRECTOR OF PAYOR CONTRACTING)
- **Authorized official phone:** (912) 732-1504

## Contact information

- **Practice address:** 600 FREEMASON DR, ELIZABETHTOWN, PA 17022-3200
- **Practice address phone:** (717) 366-2466
- **Mailing address:** 600 FREEMASON DR, ELIZABETHTOWN, PA 17022-3200
- **Mailing address phone:** (717) 366-2466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2026
- **Last updated:** 05/14/2026