MEDICARE: DR. GAIL MARIDA DAVIS D.D.S., M.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
1	1223E0200X	Endodontics	11210	MD

General Provider Information

NPI Number	:	1700864840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL MARIDA DAVIS D.D.S., M.S.

Provider Business Mailing Address
First Line	:	11908 DARNESTOWN RD
Second Line	:	SUITE F
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2295
Country	:	US
Telephone Number	:	301-947-3400
Fax Number	:	301-947-5778

Provider Business Practice Location Address
First Line	:	11908 DARNESTOWN RD
Second Line	:	SUITE F
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2295
Country	:	US
Telephone Number	:	301-947-3400
Fax Number	:	301-947-5778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/08/2007

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