Provider Demographics
NPI:1700999729
Name:WARREN, WILLIAM F JR (DDS MS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:WARREN
Suffix:JR
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2650 WASHBURN WY
Mailing Address - Street 2:STE 100
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4596
Mailing Address - Country:US
Mailing Address - Phone:541-882-6800
Mailing Address - Fax:541-882-6811
Practice Address - Street 1:2650 WASHBURN WY
Practice Address - Street 2:STE 100
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4596
Practice Address - Country:US
Practice Address - Phone:541-882-6800
Practice Address - Fax:541-882-6811
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD85471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics