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Organization
GRACE A. WARREN DDS, CORP
Active
Organization
GRACE A. WARREN DDS, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE ANN WARREN DDS (PRESIDENT)
(612) 721-1272
Entity
Organization
Contact information
Practice address
4110 CEDAR AVE S, MINNEAPOLIS, MN 55407-3433
(612) 721-1272
(612) 721-1803
Mailing address
4110 CEDAR AVE S, MINNEAPOLIS, MN 55407-3433
(612) 721-1272
(612) 721-1803
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143320200
—
MN
Enumeration date
09/11/2020
Last updated
10/06/2020
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