Dr. Clarice R. White | |
12173 Main St Ste B Mason TN 38049-7054 | |
(901) 294-2634 | |
(901) 294-2639 |
Full Name | Dr. Clarice R. White |
---|---|
Speciality | Dentist - General Practice |
Location | 12173 Main St Ste B, Mason, Tennessee |
Authorized Official Name and Position | Clarice R White (OWNER/PRESIDENT) |
Authorized Official Contact | 9012942634 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dr. Clarice R. White Po Box 310 Stanton TN 38069-0310 Ph: (901) 294-2634 | Dr. Clarice R. White 12173 Main St Ste B Mason TN 38049-7054 Ph: (901) 294-2634 |
NPI Number | 1235448598 |
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Provider Enumeration Date | 10/04/2010 |
Last Update Date | 10/04/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235448598 | NPI | - | NPPES |
3225536 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 5088 (Tennessee) | Primary |