Individual
BOB WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
301 POST OFFICE ST, BRYAN, TX 77801-2142
(979) 209-7275
Mailing address
710 S ROSEMARY DR, BRYAN, TX 77802-4333
(979) 846-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9012
TX
1223G0001X
General Practice Dentistry
Primary
9012
TX
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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