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General NPI Number Information
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NPI Number | 1306092861
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Entity Type | Organization
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Legal Business Name | DAVIS ORTHODONTICS
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 400 N BROADWAY
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City | ESCONDIDO
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State | CA
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Zip | 92025-2718
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Country | US
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Telephone | 760-781-1086
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Fax | 760-781-1089
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Provider Business Mailing Address
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Address Line | 400 N BROADWAY
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City | ESCONDIDO
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State | CA
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Zip | 92025-2718
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Country | US
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Telephone | 760-781-1086
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Fax | 760-781-1089
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ALLEN G. DAVIS
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Credential | D.D.S., M.S.
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Telephone | 760-781-1086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 29576
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License Number State | CA
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