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General NPI Number Information
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NPI Number | 1093546210
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Entity Type | Organization
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Legal Business Name | D.E. WARREN, PLLC
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 6668 HIGHWAY 98 WEST SUITE G
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-475-9608
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Fax |
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Provider Business Mailing Address
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Address Line | 6668 HIGHWAY 98 WEST SUITE G
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEREK WARREN
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Credential | DMD
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Telephone | 601-475-9608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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