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General NPI Number Information
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NPI Number | 1508490228
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Entity Type | Organization
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Legal Business Name | DAVIS DENTAL CENTERS, PC
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Dates
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Enumeration Date | 03/03/2020
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 326 MAIN ST
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City | CUMBERLAND
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State | ME
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Zip | 04021-3904
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Country | US
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Telephone | 207-829-5937
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Fax |
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Provider Business Mailing Address
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Address Line | 140 KELSEY RIDGE RD
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City | FREEPORT
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State | ME
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Zip | 04032-6475
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Country | US
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Telephone |
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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. RONALD DAVIS
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Credential | DDS
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Telephone | 540-908-0651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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