Provider Demographics
NPI:1134191968
Name:DELUTY, WARREN P (DDS)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:P
Last Name:DELUTY
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 1:333 WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2532
Mailing Address - Country:US
Mailing Address - Phone:516-481-8816
Mailing Address - Fax:516-481-4310
Practice Address - Street 1:333 WOODFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2532
Practice Address - Country:US
Practice Address - Phone:516-481-8816
Practice Address - Fax:516-481-4310
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0346391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice