Provider Demographics
NPI:1609063288
Name:R. LEE WARREN, DDS AND ERIC J. GRIMES, DDS, PLLC
Entity Type:Organization
Organization Name:R. LEE WARREN, DDS AND ERIC J. GRIMES, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANDREWS
Authorized Official - Last Name:W
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-264-2762
Mailing Address - Street 1:142 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5000
Mailing Address - Country:US
Mailing Address - Phone:828-264-2762
Mailing Address - Fax:828-264-7738
Practice Address - Street 1:142 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5000
Practice Address - Country:US
Practice Address - Phone:828-264-2762
Practice Address - Fax:828-264-7738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty