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General NPI Number Information
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NPI Number | 1528155405
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Entity Type | Individual
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Provider Name | ALFRED B. WARREN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 3337 SE SALERNO RD
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City | STUART
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State | FL
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Zip | 34997-6736
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Country | US
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Telephone | 772-285-0791
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1515
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City | PORT SALERNO
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State | FL
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Zip | 34992-1515
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Country | US
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Telephone | 772-285-0791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN5018
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License Number State | FL
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