Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | DA0000003538 | TN |
NPI | 1285732842 |
---|---|
Provider Name | Ms. Sherry D White |
First Address | Savannah, TN 38372-0094 |
Second Address | Savannah, TN 38372-2078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |