Provider Demographics
NPI:1194166561
Name:DAVID WARREN DDS INC
Entity type:Organization
Organization Name:DAVID WARREN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-435-9229
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty