Healthcare Provider Details

I. General information

NPI: 1710142583
Provider Name (Legal Business Name): DAVID SCOTT BERRIOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 02/17/2024
Certification Date: 02/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72650 FRED WARING DR STE 207
PALM DESERT CA
92260-5009
US

IV. Provider business mailing address

72650 FRED WARING DR STE 207
PALM DESERT CA
92260-5009
US

V. Phone/Fax

Practice location:
  • Phone: 760-340-3341
  • Fax:
Mailing address:
  • Phone: 760-340-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number46457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: