Provider Demographics
NPI:1245710151
Name:WARREN B. BRANCH DDS PLLC
Entity type:Organization
Organization Name:WARREN B. BRANCH DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:BOOWELL
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-653-8398
Mailing Address - Street 1:3301 OAKWELL CT STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3074
Mailing Address - Country:US
Mailing Address - Phone:210-653-8398
Mailing Address - Fax:210-653-9533
Practice Address - Street 1:3301 OAKWELL CT STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3074
Practice Address - Country:US
Practice Address - Phone:210-653-8398
Practice Address - Fax:210-653-9533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty