| Dr William White Pc | |
|
225 Gooding St La Salle IL 61301-2442 | |
| (815) 224-1865 | |
| Not Available |
| Full Name | Dr William White Pc |
|---|---|
| Speciality | Dentist |
| Location | 225 Gooding St, La Salle, Illinois |
| Authorized Official Name and Position | William Michael White (PRESIDENT) |
| Authorized Official Contact | 8152241865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr William White Pc 225 Gooding St La Salle IL 61301-2442 Ph: (815) 224-1865 | Dr William White Pc 225 Gooding St La Salle IL 61301-2442 Ph: (815) 224-1865 |
| NPI Number | 1568786341 |
|---|---|
| Provider Enumeration Date | 03/23/2010 |
| Last Update Date | 03/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568786341 | NPI | - | NPPES |
| 101268 | Medicaid | IL | |
| 1004181 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019018468 (Illinois) | Primary |