Provider Demographics
NPI:1467902205
Name:WARREN DENTAL & SPECIALTY GROUP, LLC
Entity Type:Organization
Organization Name:WARREN DENTAL & SPECIALTY GROUP, LLC
Other - Org Name:BRIGHTER DENTAL CARE (WARREN)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-252-9000
Mailing Address - Street 1:55 MOUNTAIN BLVD
Mailing Address - Street 2:BUILDING 2, SUITE 205
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-2615
Mailing Address - Country:US
Mailing Address - Phone:908-753-2700
Mailing Address - Fax:908-753-2705
Practice Address - Street 1:55 MOUNTAIN BLVD
Practice Address - Street 2:BUILDING 2, SUITE 205
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2615
Practice Address - Country:US
Practice Address - Phone:908-753-2700
Practice Address - Fax:908-753-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02175000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty