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General NPI Number Information
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NPI Number | 1881756203
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Entity Type | Organization
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Legal Business Name | WARREN DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 634 MAIN STREET
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City | WARREN
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State | RI
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Zip | 02809
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Country | US
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Telephone | 401-245-5825
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Fax | 401-245-0936
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Provider Business Mailing Address
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Address Line | 634 MAIN STREET
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City | WARREN
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State | RI
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Zip | 02809
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Country | US
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Telephone | 401-245-5825
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Fax | 401-245-0936
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOHN FRANCIS KERWIN
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Credential | DDS
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Telephone | 401-245-5825
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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 | DEN01871
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License Number State | RI
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