Healthcare Provider Details

I. General information

NPI: 1396860193
Provider Name (Legal Business Name): CURT ALAN WARREN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10439 COMMERCE DR. SUITE 120
CARMEL IN
46032-7605
US

IV. Provider business mailing address

10439 COMMERCE DR. SUITE 120
CARMEL IN
46032-7605
US

V. Phone/Fax

Practice location:
  • Phone: 317-876-3636
  • Fax: 317-876-3336
Mailing address:
  • Phone: 317-876-3636
  • Fax: 317-876-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12009986
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: