Provider Demographics
NPI:1871634287
Name:WARNER & WARNER PLLC
Entity Type:Organization
Organization Name:WARNER & WARNER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-260-4172
Mailing Address - Street 1:601 SE 117TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5297
Mailing Address - Country:US
Mailing Address - Phone:360-260-4172
Mailing Address - Fax:360-260-3955
Practice Address - Street 1:601 SE 117TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5297
Practice Address - Country:US
Practice Address - Phone:360-260-4172
Practice Address - Fax:360-260-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA44111223G0001X
WA76441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5042510Medicaid
WA5042494Medicaid