Provider Demographics
NPI:1679252381
Name:WARREN, ABIGAIL CRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:CRISTINE
Last Name:WARREN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:CRISTINE
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2915 HARDSMITH ST
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-4697
Mailing Address - Country:US
Mailing Address - Phone:252-907-2862
Mailing Address - Fax:
Practice Address - Street 1:5080 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4488
Practice Address - Country:US
Practice Address - Phone:252-907-2862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice