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Organization

MAE WHITE DENTISTRY, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAE T WHITE D.D.S. (DENTIST)
(404) 349-4343
Entity
Organization

Contact information

Practice address
2291 FAIRBURN RD SW, ATLANTA, GA 30331-5038
(404) 349-4343
(404) 349-4344
Mailing address
2291 FAIRBURN RD SW, ATLANTA, GA 30331-5038
(404) 349-4343
(404) 349-4344

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8467
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000163127A
GA
Enumeration date
03/27/2013
Last updated
03/27/2013
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