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DR. FRED ASHLEY WHITE D.D.S.

>> Dentist >> Dental Providers

Registrant NPI Number: 1073651436

Individual Registrant:
DR. FRED ASHLEY WHITE D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
6605 SE 221ST ST  HAWTHORNE, FL 32640-3815 US
Tel: 352-481-2741  Fax: --

Contact information for business:
PO BOX 10  HAWTHORNE, FL 32640-0010 US
Tel: 352-481-2741  Fax: --

Registration Information:
NPI: 1073651436
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
FLDN12468

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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