# LARRY WARECK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558801720
- **Authorized official:** RENEE WARECK MANAGER (WIFE)
- **Authorized official phone:** (231) 276-9051

## Contact information

- **Practice address:** 2120 M 137 \# 95, INTERLOCHEN, MI 49643-9386
- **Practice address phone:** (231) 276-9051
- **Mailing address:** 2120 M 137 \# 95, INTERLOCHEN, MI 49643-9386
- **Mailing address phone:** (231) 276-9051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901013338 | MI | Yes |

## Other

- **Enumeration date:** 03/07/2017
- **Last updated:** 03/07/2017