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General NPI Number Information
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NPI Number | 1346320959
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Entity Type | Organization
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Legal Business Name | REBECCA DAVIS, D.D.S., P.C.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 1330 E 9TH ST
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City | CUSHING
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State | OK
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Zip | 74023-4642
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Country | US
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Telephone | 918-225-1356
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Fax | 918-225-3207
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Provider Business Mailing Address
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Address Line | 1330 E 9TH ST
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City | CUSHING
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State | OK
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Zip | 74023-4642
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Country | US
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Telephone | 918-225-1356
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Fax | 918-225-3207
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REBECCA L DAVIS
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Credential | D.D.S.
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Telephone | 918-225-1356
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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 | 5188
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License Number State | OK
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