Provider Demographics
NPI:1851384069
Name:WARREN, LON JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:LON
Middle Name:JAMES
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:UNIT 3865
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09137
Mailing Address - Country:DE
Mailing Address - Phone:004-965-6561
Mailing Address - Fax:8229
Practice Address - Street 1:UNIT 3865
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09137
Practice Address - Country:DE
Practice Address - Phone:004-965-6561
Practice Address - Fax:8229
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA071341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice