# DR. MICHAEL G WARREN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124135900
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12007305A | IN | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 12/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100108820A | — | IN |
| 01 | — | 200130 | CHILDREN'S SPECIAL HEALTH | IN |
| 01 | — | 612224 | UNITED CONCORDIA | IN |