Provider Demographics
NPI:1114043031
Name:WARREN V WINGATE DDS INC
Entity Type:Organization
Organization Name:WARREN V WINGATE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:VERON
Authorized Official - Last Name:WINGATE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-372-4599
Mailing Address - Street 1:1237 NORTH MONROE DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-6609
Mailing Address - Country:US
Mailing Address - Phone:937-372-4599
Mailing Address - Fax:937-372-4110
Practice Address - Street 1:1237 NORTH MONROE DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-6609
Practice Address - Country:US
Practice Address - Phone:937-372-4599
Practice Address - Fax:937-372-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty