Provider Demographics
NPI:1528506151
Name:CONSTANT, DAVID T (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:CONSTANT
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 1:10393 TORRE AVE STE K
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3235
Mailing Address - Country:US
Mailing Address - Phone:408-996-2909
Mailing Address - Fax:
Practice Address - Street 1:10393 TORRE AVE STE K
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3235
Practice Address - Country:US
Practice Address - Phone:408-996-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA346001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics