MEDICARE: WARREN & WARREN FAMILY DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		NC

General Provider Information

NPI Number	:	1063421337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN & WARREN FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	PO BOX 12791
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28561-2791
Country	:	US
Telephone Number	:	252-633-6111
Fax Number	:	252-633-6262

Provider Business Practice Location Address
First Line	:	2129 S GLENBURNIE RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2240
Country	:	US
Telephone Number	:	252-633-6111
Fax Number	:	252-633-6262

Authorized Official
Title or Position	:	DR.
Name	:	MELINDA BELL WARREN
Credential	:	D.D.S.
Telephone Number	:	252-633-6111

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	09/13/2007

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