Provider Demographics
NPI:1972874865
Name:RICH, WARREN MERTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:MERTON
Last Name:RICH
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 1:16370 US HIGHWAY 17 N
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3300
Mailing Address - Country:US
Mailing Address - Phone:910-270-3602
Mailing Address - Fax:910-270-3603
Practice Address - Street 1:16370 US HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3300
Practice Address - Country:US
Practice Address - Phone:910-270-3602
Practice Address - Fax:910-270-3603
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist