Provider Demographics
NPI:1588772057
Name:THOMAS WHITE, CAROL L (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:L
Last Name:THOMAS WHITE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S LOOP 336 W # D
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3300
Mailing Address - Country:US
Mailing Address - Phone:936-760-1737
Mailing Address - Fax:936-340-9072
Practice Address - Street 1:206 SOUTH LOOP 336 WEST # D
Practice Address - Street 2:RIVER POINTE DENTAL
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3300
Practice Address - Country:US
Practice Address - Phone:936-760-1737
Practice Address - Fax:936-340-9072
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist