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General NPI Number Information
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NPI Number | 1598286379
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Entity Type | Individual
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Provider Name | DUSTIN DAVIS DPM
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Gender | Male
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1825 E MAIN ST STE A
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City | MONTROSE
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State | CO
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Zip | 81401-3848
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Country | US
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Telephone | 970-240-3338
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Fax | 970-240-1541
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Provider Business Mailing Address
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Address Line | PO BOX 21150
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City | BOULDER
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State | CO
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Zip | 80308-4150
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Country | US
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Telephone | 970-240-3338
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Fax | 970-240-1541
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD.0000883
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License Number State | CO
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