Provider Demographics
NPI:1275870362
Name:PHIL WARLICK, DDS, INC
Entity Type:Organization
Organization Name:PHIL WARLICK, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:WARLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-738-6446
Mailing Address - Street 1:620 S ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:WALSENBURG
Mailing Address - State:CO
Mailing Address - Zip Code:81089-2240
Mailing Address - Country:US
Mailing Address - Phone:719-738-6446
Mailing Address - Fax:719-738-3773
Practice Address - Street 1:620 S ALBERT AVE
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-2240
Practice Address - Country:US
Practice Address - Phone:719-738-6446
Practice Address - Fax:719-738-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty