Provider Demographics
NPI:1063643914
Name:LOVE, DAVID BRENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRENT
Last Name:LOVE
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 1:26365 CARMEL RANCHO BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8744
Mailing Address - Country:US
Mailing Address - Phone:831-624-3549
Mailing Address - Fax:831-624-3239
Practice Address - Street 1:26365 CARMEL RANCHO BLVD STE E
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8744
Practice Address - Country:US
Practice Address - Phone:831-624-3549
Practice Address - Fax:831-624-3239
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice