Provider Demographics
NPI:1740495209
Name:DRS. WARREN & HARDEE, P.A.
Entity type:Organization
Organization Name:DRS. WARREN & HARDEE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:BARROW
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-753-5516
Mailing Address - Street 1:3467 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-1466
Mailing Address - Country:US
Mailing Address - Phone:252-753-5516
Mailing Address - Fax:252-753-6288
Practice Address - Street 1:3467 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828-1466
Practice Address - Country:US
Practice Address - Phone:252-753-5516
Practice Address - Fax:252-753-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty