Individual
NICOLE MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4320 OSAGE BEACH PARKWAY, SUITE A, OSAGE BEACH, MO 65065
(573) 348-1466
(573) 348-1581
Mailing address
4320 OSAGE BEACH PARKWAY, SUITE A, OSAGE BEACH, MO 65065
(573) 348-1466
(573) 348-1581
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2008015096
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407015456
—
MO
Enumeration date
06/05/2008
Last updated
03/07/2023
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