Individual
ANDREW S WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4 S HOSPITAL DR, MURPHYSBORO, IL 62966-3333
(618) 684-2321
Mailing address
109 CALIFORNIA ST, CARTERVILLE, IL 62918-1923
(618) 985-8221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028752
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019028752
STATE LICENSE
IL
Enumeration date
07/21/2011
Last updated
11/13/2014
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