Provider Demographics
NPI:1265255723
Name:WARNER ENDODONTICS, PLLC
Entity type:Organization
Organization Name:WARNER ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-722-4111
Mailing Address - Street 1:5400 IDYLWILD TR
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:720-722-4111
Mailing Address - Fax:720-823-3444
Practice Address - Street 1:5400 IDYLWILD TR
Practice Address - Street 2:SUITE C
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:720-722-4111
Practice Address - Fax:720-823-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty