Provider Demographics
NPI:1174746002
Name:WHITE, HARRY L (DMD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3 CRYSTAL VIEW RDG
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7958
Mailing Address - Country:US
Mailing Address - Phone:949-363-7520
Mailing Address - Fax:949-363-1829
Practice Address - Street 1:23800 ALISO CREEK RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3930
Practice Address - Country:US
Practice Address - Phone:949-831-5500
Practice Address - Fax:949-448-7795
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADX253071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics