Provider Demographics
NPI:1295894004
Name:WARN, BRETT RANDAL (DDS)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:RANDAL
Last Name:WARN
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 1:5103 NW CACHE RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3415
Mailing Address - Country:US
Mailing Address - Phone:580-248-4224
Mailing Address - Fax:580-248-4299
Practice Address - Street 1:5103 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3415
Practice Address - Country:US
Practice Address - Phone:580-248-4224
Practice Address - Fax:580-248-4299
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK52471223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice