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General NPI Number Information
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NPI Number | 1720212145
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Entity Type | Organization
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Legal Business Name | HENRY W. DAVIS,JR. II, DDS, PLLC
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 2401 CAPITAL BLVD
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City | RALEIGH
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State | NC
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Zip | 27604-2236
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Country | US
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Telephone | 919-833-1920
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Fax | 919-833-1968
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Provider Business Mailing Address
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Address Line | 596B E JACKSON BLVD
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City | ERWIN
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State | NC
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Zip | 28339-9629
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Country | US
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Telephone | 910-892-4535
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Fax | 910-892-0255
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY W DAVIS JR.
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Credential | DDS
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Telephone | 910-892-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5140
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License Number State | NC
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