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General NPI Number Information
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NPI Number | 1275787160
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Entity Type | Organization
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Legal Business Name | DR.DANNY E DAVIDSON, DDS PS
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 108 22ND AVE SW #16
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City | OLYMPIA
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State | WA
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Zip | 98501-2871
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Country | US
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Telephone | 360-943-5775
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Fax | 360-943-6349
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Provider Business Mailing Address
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Address Line | 108 22ND AVE SW #16
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City | OLYMPIA
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State | WA
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Zip | 98501-2871
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Country | US
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Telephone | 360-943-5775
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Fax | 360-943-6349
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANNY EUGENE DAVIDSON
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Credential | DDS
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Telephone | 360-943-5775
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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 | 5699
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License Number State | WA
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