Provider Demographics
NPI:1316121130
Name:WARREN, LINDA TRUBILLA (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:TRUBILLA
Last Name:WARREN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CETRONIA ROAD
Mailing Address - Street 2:SUITE 121 S
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104
Mailing Address - Country:US
Mailing Address - Phone:610-395-4830
Mailing Address - Fax:
Practice Address - Street 1:240 CETRONIA ROAD
Practice Address - Street 2:SUITE 121 S
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-395-4830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030694L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice