Provider Demographics
NPI:1528547072
Name:WARR, MARIA ROSS (RDH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ROSS
Last Name:WARR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2602
Mailing Address - Country:US
Mailing Address - Phone:248-425-4563
Mailing Address - Fax:
Practice Address - Street 1:53 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1109
Practice Address - Country:US
Practice Address - Phone:248-268-2093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902003469124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist