Individual
ALFRED B. WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3337 SE SALERNO RD, STUART, FL 34997-6736
(772) 285-0791
Mailing address
PO BOX 1515, PORT SALERNO, FL 34992-1515
(772) 285-0791
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN5018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000658300
—
FL
01
—
760706979
TAX I.D.
FL
Enumeration date
10/10/2006
Last updated
08/24/2011
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