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General NPI Number Information
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NPI Number | 1548607294
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Entity Type | Organization
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Legal Business Name | DOCTORS BILL AND DAVIS DENTISTRY, PLLC
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 10660 SOUTHERN HIGHLANDS PKWY SUITE 110
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City | LAS VEGAS
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State | NV
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Zip | 89141-4114
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Country | US
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Telephone | 702-477-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 10660 SOUTHERN HIGHLANDS PKWY SUITE #110
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City | LAS VEGAS
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State | NV
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Zip | 89141-4114
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Country | US
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Telephone | 702-477-0040
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JAY E DAVIS
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Credential | DMD, MS
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Telephone | 702-477-0040
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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 | S6-121
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-233
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License Number State | NV
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