Provider Demographics
NPI:1487027355
Name:WARRENTON DENTAL CARE
Entity Type:Organization
Organization Name:WARRENTON DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHEARER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-347-2233
Mailing Address - Street 1:381 STUYVESANT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2400
Mailing Address - Country:US
Mailing Address - Phone:540-347-2233
Mailing Address - Fax:540-341-4700
Practice Address - Street 1:381 STUYVESANT ST STE 3
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2400
Practice Address - Country:US
Practice Address - Phone:540-347-2233
Practice Address - Fax:540-341-4700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC DENTAL CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014124811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty