Provider Demographics
NPI:1518970854
Name:CREED, WARREN LEROY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:LEROY
Last Name:CREED
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500169
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-0169
Mailing Address - Country:US
Mailing Address - Phone:670-234-6323
Mailing Address - Fax:
Practice Address - Street 1:QUARTERMASTER ROAD
Practice Address - Street 2:CHALAN LAULAU
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-0169
Practice Address - Country:US
Practice Address - Phone:670-234-6323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP1221223G0001X
AZ35701223X0400X
ORD77051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics