MEDICARE: DR. GARY EVERARD WARNER D.D.S.

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	122300000X	Dentist	12139	MD
2	122300000X	Dentist	1000739	DC

General Provider Information

NPI Number	:	1245272350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY EVERARD WARNER D.D.S.

Provider Business Mailing Address
First Line	:	7603 GEORGIA AVE NW STE 403
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1617
Country	:	US
Telephone Number	:	202-723-2131
Fax Number	:	202-882-6657

Provider Business Practice Location Address
First Line	:	7610 PENNSYLVANIA AVENUE
Second Line	:	SUITE 302
City	:	FORESTVILLE
State	:	MD
Zip	:	20747
Country	:	US
Telephone Number	:	301-735-5137
Fax Number	:	301-735-5389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/24/2023

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