Individual
BRANDON KEITH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8642 FOREST RD, GOODE, VA 24556-3027
(540) 587-5707
Mailing address
2409 CAROLINA AVE SW, ROANOKE, VA 24014-2305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414027
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401414027
VA STATE DENTAL LICENSE
VA
Enumeration date
06/19/2013
Last updated
05/13/2020
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