MEDICARE: MR. WARREN DANICK DDS

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	3769	MD

General Provider Information

NPI Number	:	1679607220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WARREN DANICK DDS

Provider Business Mailing Address
First Line	:	7825 TUCKERMAN LANE
Second Line	:	SUITE 207
City	:	POTOMAC
State	:	MD
Zip	:	20854-3241
Country	:	US
Telephone Number	:	301-299-7757
Fax Number	:	301-299-4163

Provider Business Practice Location Address
First Line	:	7825 TUCKERMAN LANE
Second Line	:	SUITE 207
City	:	POTOMAC
State	:	MD
Zip	:	20854-3241
Country	:	US
Telephone Number	:	301-299-7757
Fax Number	:	301-299-4163

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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