Provider Demographics
NPI:1346918398
Name:WHITE, BENJAMIN ALEXANDER JR (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ALEXANDER
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 PINE BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-4974
Mailing Address - Country:US
Mailing Address - Phone:617-872-7383
Mailing Address - Fax:
Practice Address - Street 1:198 PINE BRANCH CT
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-4974
Practice Address - Country:US
Practice Address - Phone:617-872-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51961223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health