Provider Demographics
NPI:1275531311
Name:BRANCH, WARREN BOSWELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:BOSWELL
Last Name:BRANCH
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 1:134 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-1720
Mailing Address - Country:US
Mailing Address - Phone:210-822-1012
Mailing Address - Fax:
Practice Address - Street 1:3301 OAKWELL CT
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3074
Practice Address - Country:US
Practice Address - Phone:210-653-8398
Practice Address - Fax:210-653-9533
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice