Provider Demographics
NPI:1891860284
Name:WARNER, JOHN GREER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GREER
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-0073
Mailing Address - Country:US
Mailing Address - Phone:970-453-9615
Mailing Address - Fax:970-453-2080
Practice Address - Street 1:100 S. RIDGE ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424
Practice Address - Country:US
Practice Address - Phone:970-453-9615
Practice Address - Fax:970-453-2080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1045421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice