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Individual

DENNIS LEE WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1100 W SCENIC RIVERS BLVD, SUITE A, SALEM, MO 65560-2811
(573) 729-4300
(573) 729-4359
Mailing address
1100 W SCENIC RIVERS BLVD, SUITE A, SALEM, MO 65560-2811
(573) 729-4300
(573) 729-4359

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02817
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
109138
BCBS OF MO
MO
01
2200821
UNITED HEALTHCARE
05
312683105
MO
Enumeration date
04/06/2006
Last updated
05/06/2015
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