Provider Demographics
NPI:1598125056
Name:WARREN R. STENVALL LLC
Entity Type:Organization
Organization Name:WARREN R. STENVALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STENVALL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-214-2512
Mailing Address - Street 1:31 BIG SPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31 BIG SPRING RD
Practice Address - Street 2:
Practice Address - City:CALIFON
Practice Address - State:NJ
Practice Address - Zip Code:07830-3427
Practice Address - Country:US
Practice Address - Phone:908-975-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ10861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty