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General NPI Number Information
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NPI Number | 1669778650
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Entity Type | Organization
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Legal Business Name | DAVIS ENDODONTICS
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 11908 DARNESTOWN RD SUITE #F
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-947-3400
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Fax | 301-947-5778
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Provider Business Mailing Address
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Address Line | 11908 DARNESTOWN RD SUITE #F
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-947-3400
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Fax | 301-947-5778
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Authorized Official
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Title or Position | ENDODONTIST/DENTIST
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Name | GAIL M. DAVIS
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Credential | DDS, MS, PC
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Telephone | 301-947-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 11210
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License Number State | MD
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