Provider Demographics
NPI:1083060719
Name:GALL, WARREN NIKOLAUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:NIKOLAUS
Last Name:GALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 WINFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8483
Mailing Address - Country:US
Mailing Address - Phone:563-581-1859
Mailing Address - Fax:
Practice Address - Street 1:69 E WILSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2301
Practice Address - Country:US
Practice Address - Phone:614-431-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.24712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist