Provider Demographics
NPI:1285787200
Name:WARMFLASH, BERNARD G (DDS)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:G
Last Name:WARMFLASH
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 1:332 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3016
Mailing Address - Country:US
Mailing Address - Phone:203-322-3131
Mailing Address - Fax:203-322-3131
Practice Address - Street 1:332 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3016
Practice Address - Country:US
Practice Address - Phone:203-322-3131
Practice Address - Fax:203-322-3131
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT30721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2030724Medicaid