Individual
DR. KENNETH WAYNE WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8525 PIT STOP CT NW STE A, CONCORD, NC 28027-8338
(704) 548-2700
Mailing address
128 STUART AVE, SOUTHPORT, NC 28461-3062
(910) 523-0767
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11902
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2020
Last updated
08/04/2020
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