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General NPI Number Information
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NPI Number | 1194555862
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Entity Type | Individual
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Provider Name | CASEY DAVIS DDS
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Gender | Male
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Dates
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Enumeration Date | 08/06/2024
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 3D DENTAL BN/3MLG UNIT 38450
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City | FPO
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State | AP
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Zip | 96373-8450
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Country | US
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Telephone | 315-645-2390
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Fax |
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Provider Business Mailing Address
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Address Line | 3D DENTAL BN/3MLG UNIT 38450
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City | FPO
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State | AP
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Zip | 96373-8450
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Country | US
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Telephone | 315-645-2390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.027505
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License Number State | OH
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