Provider Demographics
NPI:1558732396
Name:WARNER FAMILY DENTISTRY, LLC
Entity Type:Organization
Organization Name:WARNER FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-803-0333
Mailing Address - Street 1:303 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2155
Mailing Address - Country:US
Mailing Address - Phone:662-323-1339
Mailing Address - Fax:662-324-0554
Practice Address - Street 1:303 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2155
Practice Address - Country:US
Practice Address - Phone:662-323-1339
Practice Address - Fax:662-324-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3589-111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty