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General NPI Number Information
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NPI Number | 1154548469
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Entity Type | Organization
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Legal Business Name | MICHAEL A. WARREN CAPTIAL INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 111 W WIGWAM BLVD SUITE A
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4636
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Country | US
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Telephone | 623-935-9376
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Fax | 623-536-9884
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Provider Business Mailing Address
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Address Line | 111 W WIGWAM BLVD SUITE A
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4636
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Country | US
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Telephone | 623-935-9376
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Fax | 623-536-9884
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL ANTHONY WARREN
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Credential | D.D.S.
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Telephone | 623-935-9376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D4840
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License Number State | AZ
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