Provider Demographics
NPI:1508980632
Name:WARREN & GIBSON LLC
Entity Type:Organization
Organization Name:WARREN & GIBSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLSCHBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-878-9562
Mailing Address - Street 1:5109 W BROAD ST
Mailing Address - Street 2:SUITE303
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1648
Mailing Address - Country:US
Mailing Address - Phone:614-878-9562
Mailing Address - Fax:614-878-1468
Practice Address - Street 1:5109 W BROAD ST
Practice Address - Street 2:SUITE303
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1648
Practice Address - Country:US
Practice Address - Phone:614-878-9562
Practice Address - Fax:614-878-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145841223G0001X
OH216251223G0001X
OH144701223G0001X
OH202691223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty