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General NPI Number Information
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NPI Number | 1720376205
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Entity Type | Organization
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Legal Business Name | JOHN D DAVIS D.D.S.
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 1501 S 9TH ST
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City | IRONTON
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State | OH
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Zip | 45638-2225
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Country | US
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Telephone | 740-532-6520
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Fax | 740-532-9564
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Provider Business Mailing Address
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Address Line | 1501 S 9TH ST
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City | IRONTON
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State | OH
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Zip | 45638-2225
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Country | US
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Telephone | 740-532-6520
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Fax | 740-532-9564
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN D DAVIS
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Credential | DDS
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Telephone | 740-532-6520
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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 | 30013864
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License Number State | OH
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