Warren, Grace Ann

Warren, Grace Ann is an individual health care provider with primary practice located at 4110 Cedar Ave S , Minneapolis MN 55407-3433. She recently has 2 registered licenses in different health care specialties including Dental Providers / Endodontics, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Warren, Grace Ann can be contacted via phone (612) 721-1272.

Contact Information

Primary practice address
4110 Cedar Ave S Minneapolis MN 55407-3433
Phone: (612) 721-1272
Fax: (612) 721-1803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 9504 Minnesota
Dental Providers / General Practice 1223G0001X 9504 Minnesota

Profile Details

NPI number 1174638613
LBN Legal business name Warren, Grace Ann
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated Dec 9th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174638613 NPPES
Minnesota MEDICAID 143320200

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