Provider Demographics
NPI:1083602528
Name:BRILL, WARREN A (DMD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:A
Last Name:BRILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3413
Mailing Address - Country:US
Mailing Address - Phone:410-282-8900
Mailing Address - Fax:410-284-5781
Practice Address - Street 1:1001 N POINT BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3413
Practice Address - Country:US
Practice Address - Phone:410-282-8900
Practice Address - Fax:410-284-5781
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD53781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry