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NPI Code Detail

MEDICARE: DR. THOMAS MICHAEL DAVIDSON D.D.S.

MEDICARE:  DR. THOMAS MICHAEL DAVIDSON  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2901017188MI

General Provider Information

NPI Number : 1568553857
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS MICHAEL DAVIDSON D.D.S.
Provider Business Mailing Address
First Line : 58047 VAN DYKE RD
Second Line : SUITE# 101
City : WASHINGTON
State : MI
Zip : 48094-4000
Country : US
Telephone Number : 586-270-6013
Fax Number : 586-207-6300
Provider Business Practice Location Address
First Line : 58047 VAN DYKE RD
Second Line : SUITE# 101
City : WASHINGTON
State : MI
Zip : 48094-4000
Country : US
Telephone Number : 586-270-6013
Fax Number : 586-207-6300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 06/30/2023

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Directions to “ DR. THOMAS MICHAEL DAVIDSON D.D.S.” Practice Location

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