Individual
DR. DALE DANIEL WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3651 N 100 E STE 200, PROVO, UT 84604-4553
(801) 960-3644
Mailing address
3651 N 100 E STE 200, PROVO, UT 84604-4553
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9433186-8903
UT
122300000X
Dentist
Primary
9433186-9922
UT
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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