Provider Demographics
NPI:1245272350
Name:WARNER, GARY EVERARD (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:EVERARD
Last Name:WARNER
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 1:7603 GEORGIA AVE NW STE 403
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1617
Mailing Address - Country:US
Mailing Address - Phone:202-723-2131
Mailing Address - Fax:202-882-6657
Practice Address - Street 1:7610 PENNSYLVANIA AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747
Practice Address - Country:US
Practice Address - Phone:301-735-5137
Practice Address - Fax:301-735-5389
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12139122300000X
DC1000739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist