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General NPI Number Information
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NPI Number | 1497026058
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Entity Type | Organization
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Legal Business Name | CHRISTI M. DAVIS, DDS, PA III
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 2406 BLUE RIDGE ROAD SUITE 210
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City | RALEIGH
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State | NC
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Zip | 27607-6452
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Country | US
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Telephone | 919-782-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 2406 BLUE RIDGE ROAD SUITE 210
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City | RALEIGH
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State | NC
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Zip | 27607-6452
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Country | US
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Telephone | 919-782-9560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTI MICHELLE DAVIS
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Credential | DDS
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Telephone | 919-782-9560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 7533
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License Number State | NC
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