Individual
SPENCER GARRETT WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 LENTZ DR STE 40, MADISON, TN 37115
(615) 868-9057
Mailing address
1327 CARDINAL AVE, NASHVILLE, TN 37216-2310
(931) 808-4592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.026384
OH
1223P0221X
Pediatric Dentistry
Primary
11809
TN
1223P0221X
Pediatric Dentistry
30.026384
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0439284
—
OH
Enumeration date
04/07/2020
Last updated
12/03/2024
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