| Warren Dental, Pllc | |
|
390 Factory Rd Suite A Clinton AR 72031-6742 | |
| (501) 745-4656 | |
| (501) 745-6317 |
| Full Name | Warren Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 390 Factory Rd, Clinton, Arkansas |
| Authorized Official Name and Position | Darryl W. Warren (OWNER) |
| Authorized Official Contact | 5017454656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Dental, Pllc 390 Factory Rd Suite A Clinton AR 72031-6742 Ph: (501) 745-4656 | Warren Dental, Pllc 390 Factory Rd Suite A Clinton AR 72031-6742 Ph: (501) 745-4656 |
| NPI Number | 1518085620 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 02/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518085620 | NPI | - | NPPES |
| 187471631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2140 (Arkansas) | Secondary |
| 1223G0001X | Dentist - General Practice | 3528 (Arkansas) | Primary |
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