Provider Demographics
NPI:1558548362
Name:VARELA, DAVID GIDEON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GIDEON
Last Name:VARELA
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:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-0686
Mailing Address - Country:US
Mailing Address - Phone:831-678-3951
Mailing Address - Fax:831-678-5907
Practice Address - Street 1:5 MILES NORTH OF SOLEDAD, CA ON HGWY 101
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-0686
Practice Address - Country:US
Practice Address - Phone:831-678-3951
Practice Address - Fax:831-678-5907
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice