Provider Demographics
NPI:1710025861
Name:WARNER, HOWARD JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JAY
Last Name:WARNER
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 1:44 FRANCES ST
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:13795-1025
Mailing Address - Country:US
Mailing Address - Phone:607-775-3334
Mailing Address - Fax:607-775-3336
Practice Address - Street 1:44 FRANCES ST
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:NY
Practice Address - Zip Code:13795-1025
Practice Address - Country:US
Practice Address - Phone:607-775-3334
Practice Address - Fax:607-775-3336
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0389511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice