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Individual
DR. DAVID BRENT PEMBERTON
Active
Individual
DR. DAVID BRENT PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005552
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000762638
UNITED CONCORDIA
PA
01
—
001701144
UNITED CONCORDIA
PA
01
—
077683
ANTHEM
VA
01
—
165313
DORAL DENTAL
WI
01
—
172260
ANTHEM
VA
05
—
7815042
—
VA
Enumeration date
08/05/2007
Last updated
10/16/2013
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