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General NPI Number Information
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NPI Number | 1558501775
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH DAVIS DDS
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Gender | Female
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 903 W ENNIS AVE SUITE 3
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City | ENNIS
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State | TX
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Zip | 75119-3737
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Country | US
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Telephone | 214-460-4174
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Fax |
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Provider Business Mailing Address
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Address Line | 3419 WESTMINSTER AVE #274
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City | DALLAS
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State | TX
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Zip | 75205-1387
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Country | US
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Telephone | 214-460-4174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 24089
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License Number State | TX
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