Organization
DR. C.R. WHITE AND ASSOCIATES DENTAL CENTER,INC.
Active
Other names
Dr. Clarice R. White
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARICE R WHITE DDS (OWNER/PRESIDENT)
(901) 294-2634
Entity
Organization
Contact information
Practice address
12173 MAIN ST STE B, MASON, TN 38049-7054
(901) 294-2634
(901) 294-2639
Mailing address
PO BOX 310, STANTON, TN 38069-0310
(901) 294-2634
(901) 294-2639
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5088
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3225536
—
TN
Enumeration date
10/04/2010
Last updated
10/04/2010
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