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Individual

FADI E WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 AUSTIN BLVD STE 100, RED OAK, TX 75154-4661
(469) 552-9944
Mailing address
101 E GLADE RD APT 3209, GRAPEVINE, TX 76051-7310
(586) 447-6833

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901021618
MI
122300000X
Dentist
Primary
33651
TX
1223G0001X
General Practice Dentistry
5315072202
MI

Other

Enumeration date
06/26/2015
Last updated
07/29/2022
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