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General NPI Number Information
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NPI Number | 1205447752
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Entity Type | Individual
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Provider Name | BARRET J DAVIDSON DDS
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Gender | Male
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 106 N COTTONWOOD DR
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City | RICHARDSON
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State | TX
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Zip | 75080-4736
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Country | US
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Telephone | 972-231-5376
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Fax |
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Provider Business Mailing Address
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Address Line | 6110 SAINTSBURY DR APT 318
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City | THE COLONY
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State | TX
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Zip | 75056-5291
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Country | US
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Telephone | 817-307-8182
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36462
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License Number State | TX
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