Individual
MAYA SIMONE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8179 MCGREGOR XING, OLIVE BRANCH, MS 38654-1408
(662) 408-3352
Mailing address
8179 MCGREGOR XING, OLIVE BRANCH, MS 38654-1408
(662) 408-3352
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12018
TN
122300000X
Dentist
Primary
4472-24
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2022
Last updated
08/01/2024
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