Provider Demographics
NPI:1316156904
Name:PEREZ, DAVID CARLOS (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARLOS
Last Name:PEREZ
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 1:6517 S. GREENLEAF AVE.
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4108
Mailing Address - Country:US
Mailing Address - Phone:562-945-5377
Mailing Address - Fax:
Practice Address - Street 1:6517 S. GREENLEAF AVE.
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4108
Practice Address - Country:US
Practice Address - Phone:562-945-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADW 0350501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice