Provider Demographics
NPI:1285787051
Name:WHITE, GREER AND MAGGARD, PSC
Entity type:Organization
Organization Name:WHITE, GREER AND MAGGARD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:GREG
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-296-4846
Mailing Address - Street 1:3141 BEAUMONT CENTRE CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1934
Mailing Address - Country:US
Mailing Address - Phone:859-296-4846
Mailing Address - Fax:859-296-2842
Practice Address - Street 1:3141 BEAUMONT CENTRE CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1934
Practice Address - Country:US
Practice Address - Phone:859-296-4846
Practice Address - Fax:859-296-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY62631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
272136OtherUNITED CONCORIA PROVIDER