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General NPI Number Information
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NPI Number | 1306984125
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Entity Type | Organization
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Legal Business Name | DAVIS FAMILY DENTISTRY
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2043 ANDERSON RD SUITE A
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City | DAVIS
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State | CA
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Zip | 95616-0676
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Country | US
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Telephone | 530-750-3311
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Fax | 530-750-3440
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Provider Business Mailing Address
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Address Line | 2043 ANDERSON RD SUITE A
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City | DAVIS
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State | CA
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Zip | 95616-0676
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Country | US
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Telephone | 530-750-3311
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Fax | 530-750-3440
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAFAR AFKHAM
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Credential | DDS
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Telephone | 530-750-3311
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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 | 43882
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License Number State | CA
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