Provider Demographics
NPI:1447412176
Name:WARREN, ALFRED DANIEL III (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:DANIEL
Last Name:WARREN
Suffix:III
Gender:M
Credentials:DDS, PA
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, PA
Mailing Address - Street 1:1909 TURNBURY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6168
Mailing Address - Country:US
Mailing Address - Phone:252-353-9000
Mailing Address - Fax:252-439-1473
Practice Address - Street 1:1909 TURNBURY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6168
Practice Address - Country:US
Practice Address - Phone:252-353-9000
Practice Address - Fax:252-439-1473
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics