Provider Demographics
NPI:1215156278
Name:THOMAS G. WHITE, D.D.S.,M.S.
Entity type:Organization
Organization Name:THOMAS G. WHITE, D.D.S.,M.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:360-676-1401
Mailing Address - Street 1:3628 MERIDIAN ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1735
Mailing Address - Country:US
Mailing Address - Phone:360-676-1401
Mailing Address - Fax:360-676-4097
Practice Address - Street 1:3628 MERIDIAN ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1735
Practice Address - Country:US
Practice Address - Phone:360-676-1401
Practice Address - Fax:360-676-4097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000037511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty