Provider Demographics
NPI:1538224639
Name:WARNER, DELBERT V
Entity type:Individual
Prefix:DR
First Name:DELBERT
Middle Name:V
Last Name:WARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 WESLEY CHAPEL ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034
Mailing Address - Country:US
Mailing Address - Phone:770-987-1586
Mailing Address - Fax:770-897-0045
Practice Address - Street 1:3539 WESLEY CHAPEL ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034
Practice Address - Country:US
Practice Address - Phone:770-987-1586
Practice Address - Fax:770-897-0045
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA116241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
9183143OtherDORAL
100976OtherAVESIS
GA00969251AMedicaid