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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891776845 | NPPES |
| Tennessee | MEDICAID | 3225798 | |
| Tennessee | Other | 4777 | |
| Tennessee | Other | 4098095 | |
| Tennessee | MEDICAID | 3205221 | |
| Tennessee | Other | DS005088 |
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