| Organization Name: | STEPHEN WHITE DDS LLC |
| NPI Number: | 1073888418 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN PATRICK WHITE (MANAGER) |
| Mailing Address: | 44539 Sterling Hwy Ste 203 Soldotna |
| State: | AK US |
| Postal Code: | 996697920 |
| Phone Number: | 9072628834 |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2012 |
| NPI Last Update Date: | 03/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 1413 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |