Healthcare Provider Details

I. General information

NPI: 1952229650
Provider Name (Legal Business Name): DAVIS DENTAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N 10TH ST
CENTERVILLE IA
52544-1730
US

IV. Provider business mailing address

112 N 10TH ST
CENTERVILLE IA
52544-1730
US

V. Phone/Fax

Practice location:
  • Phone: 641-856-8643
  • Fax: 641-856-8644
Mailing address:
  • Phone: 641-856-8643
  • Fax: 641-856-8644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SCOTT W DAVIS
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 641-856-8643