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Individual

DR. MICHAEL ANTHONY WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
111 W WIGWAM BLVD STE A, LITCHFIELD PARK, AZ 85340-4636
(623) 935-9376
(623) 536-9884
Mailing address
111 W WIGWAM BLVD STE A, LITCHFIELD PARK, AZ 85340-4636
(623) 935-9376
(623) 536-9884

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4840
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
542119479
T.I.N
AZ
Enumeration date
03/20/2007
Last updated
11/30/2020
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