Provider Demographics
NPI:1558970582
Name:WARREN, WILLIAM LESLIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LESLIE
Last Name:WARREN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 MALVERN AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7753
Mailing Address - Country:US
Mailing Address - Phone:501-624-2778
Mailing Address - Fax:501-321-3774
Practice Address - Street 1:1919 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7753
Practice Address - Country:US
Practice Address - Phone:501-624-2778
Practice Address - Fax:501-321-9774
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist