Provider Demographics
NPI:1215043328
Name:ERNEY, WARREN BRADLEY (DOCTOR OF DENTAL MED)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:BRADLEY
Last Name:ERNEY
Suffix:
Gender:M
Credentials:DOCTOR OF DENTAL MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19237
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403
Mailing Address - Country:US
Mailing Address - Phone:870-802-3020
Mailing Address - Fax:870-935-3203
Practice Address - Street 1:2906 BROWNS LANE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-802-3020
Practice Address - Fax:870-935-3203
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist