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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