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General NPI Number Information
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NPI Number | 1265574685
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Entity Type | Individual
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Provider Name | ALPHONZO LOWELL DAVIDSON JR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 2811 PENNSYLVANIA AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020-3865
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Country | US
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Telephone | 202-584-0710
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Fax | 202-575-3627
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Provider Business Mailing Address
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Address Line | 3308 SHORTRIDGE LN
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City | BOWIE
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State | MD
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Zip | 20721-2576
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Country | US
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Telephone | 202-528-0440
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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 | 5474
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License Number State | DC
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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 | 11379
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License Number State | MD
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