Provider Demographics
NPI:1124281670
Name:WARREN, DAVID E (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:WARREN
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 1:1317 YNEZ PL
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-3912
Mailing Address - Country:US
Mailing Address - Phone:619-435-9229
Mailing Address - Fax:619-435-6170
Practice Address - Street 1:1317 YNEZ PL
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-3912
Practice Address - Country:US
Practice Address - Phone:619-435-9229
Practice Address - Fax:619-435-6170
Is Sole Proprietor?:No
Enumeration Date:2008-07-04
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice