Healthcare Provider Details

I. General information

NPI: 1528974268
Provider Name (Legal Business Name): DAVID WARREN VO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 JUNE RD STE 105
MEMPHIS TN
38119-3722
US

IV. Provider business mailing address

1010 JUNE RD STE 105
MEMPHIS TN
38119-3722
US

V. Phone/Fax

Practice location:
  • Phone: 901-761-1515
  • Fax:
Mailing address:
  • Phone: 901-761-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13291
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: