Individual
DR. JAVONNE MCKOY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
168 NW BROAD ST, FAIRBURN, GA 30213-1436
(770) 964-1545
(770) 964-1031
Mailing address
168 NW BROAD ST, FAIRBURN, GA 30213-1436
(770) 964-1545
(770) 964-1031
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN012650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
452419657A
—
GA
Enumeration date
03/16/2006
Last updated
04/16/2014
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