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Individual
DR. CLARICE RENA WHITE
Active
Individual
DR. CLARICE RENA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000005088
TN
246RM2200X
Medical Laboratory Technician
ML0000008122
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3205221
—
TN
05
—
3225798
—
TN
01
—
4098095
BLUECROSS BLUESHIELD
TN
01
—
4777
DORAL DENTAL
TN
01
—
DS005088
LICENSE
TN
Enumeration date
11/08/2005
Last updated
06/14/2017
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