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General NPI Number Information
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NPI Number | 1588367577
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Entity Type | Organization
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Legal Business Name | DRS. KURTIS AND JOANNE DAVIS PA
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 4600 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-3850
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Country | US
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Telephone | 941-782-8052
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-3850
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Country | US
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Telephone | 941-782-8052
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KURTIS R DAVIS
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Credential | DMD
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Telephone | 678-333-7107
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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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