Provider Demographics
NPI:1336344829
Name:WARNE, GREGORY SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:WARNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 EAST GENESEE STREET
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3108
Mailing Address - Country:US
Mailing Address - Phone:315-476-7406
Mailing Address - Fax:315-476-7408
Practice Address - Street 1:600 EAST GENESEE STREET
Practice Address - Street 2:SUITE 113
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3108
Practice Address - Country:US
Practice Address - Phone:315-476-7406
Practice Address - Fax:315-476-7408
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0453431223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics