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General NPI Number Information
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NPI Number | 1114043031
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Entity Type | Organization
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Legal Business Name | WARREN V WINGATE DDS INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1237 NORTH MONROE DR
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City | XENIA
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State | OH
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Zip | 45385-6609
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Country | US
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Telephone | 937-372-4599
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Fax | 937-372-4110
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Provider Business Mailing Address
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Address Line | 1237 NORTH MONROE DR
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City | XENIA
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State | OH
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Zip | 45385-6609
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Country | US
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Telephone | 937-372-4599
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Fax | 937-372-4110
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN VERON WINGATE
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Credential | DDS
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Telephone | 937-372-4599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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