White, Clarice Rena

White, Clarice Rena is an sole proprietor health care provider with primary practice located at 12173 Main St Ste B , Mason TN 38049-7054. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Medical Laboratory, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. White, Clarice Rena can be contacted via phone (901) 294-2634.

Contact Information

Primary practice address
12173 Main St Ste B Mason TN 38049-7054
Phone: (901) 294-2634
Fax: (901) 294-2639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Medical Laboratory 246RM2200X ML0000008122 Tennessee
Dental Providers / General Practice 1223G0001X DS0000005088 Tennessee

Profile Details

NPI number 1891776845
LBN Legal business name White, Clarice Rena
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2005
Last updated Jun 14th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891776845 NPPES
Tennessee MEDICAID 3225798
Tennessee Other 4777
Tennessee Other 4098095
Tennessee MEDICAID 3205221
Tennessee Other DS005088

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