Individual
DR. IVY ELLIS WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2928 N HIGHWAY 17, MOUNT PLEASANT, SC 29466-8958
(843) 856-8856
(843) 856-8814
Mailing address
2928 N HIGHWAY 17, MOUNT PLEASANT, SC 29466-8958
(843) 856-8856
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9913
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9913
SOUTH CAROLINA DENTAL LICENSE
SC
Enumeration date
06/08/2021
Last updated
06/08/2021
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