# DR. DAVID BRENT PEMBERTON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073704219
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401005552 | VA | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 10/16/2013

## 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 |