MEDICARE: MELINDA BELL WARREN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4456	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0273C	OTHER	NC	BLUECROSS/BLUESHIELD

General Provider Information

NPI Number	:	1760491211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA BELL WARREN D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 12791
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28561-2791
Country	:	US
Telephone Number	:	252-633-6111
Fax Number	:	252-633-6262

Provider Business Practice Location Address
First Line	:	2129 S GLENBURNIE RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2240
Country	:	US
Telephone Number	:	252-633-6111
Fax Number	:	252-633-6262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	09/06/2007

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