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Organization

DR WILLIAM WHITE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM MICHAEL WHITE D.D.S. (PRESIDENT)
(815) 224-1865
Entity
Organization

Contact information

Practice address
225 GOODING ST, LA SALLE, IL 61301-2442
(815) 224-1865
Mailing address
225 GOODING ST, LA SALLE, IL 61301-2442
(815) 224-1865

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019018468
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1004181
IL
05
101268
IL
Enumeration date
03/23/2010
Last updated
03/23/2010
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