Provider Demographics
NPI:1548611775
Name:WARE, ANNIE (DMD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 ASHTON AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-5688
Mailing Address - Country:US
Mailing Address - Phone:703-369-5442
Mailing Address - Fax:703-335-9927
Practice Address - Street 1:8100 ASHTON AVE STE 212
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5688
Practice Address - Country:US
Practice Address - Phone:703-369-5442
Practice Address - Fax:703-335-9927
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist