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Individual
DR. MICHAEL G WARREN
Active
Individual
DR. MICHAEL G WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007305A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108820A
—
IN
01
—
200130
CHILDREN'S SPECIAL HEALTH
IN
01
—
612224
UNITED CONCORDIA
IN
Enumeration date
08/25/2006
Last updated
12/02/2008
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