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General NPI Number Information
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NPI Number | 1235224940
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Entity Type | Individual
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Provider Name | JOHN MICHAEL DAVIS DDS
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 113 132ND ST S
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City | TACOMA
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State | WA
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Zip | 98444-4807
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Country | US
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Telephone | 253-537-9317
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Fax | 253-537-1371
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Provider Business Mailing Address
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Address Line | 113 132ND ST S
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City | TACOMA
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State | WA
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Zip | 98444-4807
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Country | US
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Telephone | 535-379-3172
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Fax | 253-537-1371
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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 | 51333
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9916
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D5892
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License Number State | AZ
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