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General NPI Number Information
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NPI Number | 1730252982
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Entity Type | Individual
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Provider Name | TROY D DAVIDSON DDS
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 410 PEACHTREE PKWY BLDG400, SUITE 4250
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City | CUMMING
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State | GA
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Zip | 30041-7066
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Country | US
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Telephone | 770-622-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 2552 BAGLEY RD
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City | CUMMING
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State | GA
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Zip | 30041-7209
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Country | US
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Telephone | 801-602-5541
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23737
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00010701
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D-4407-PD
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 27304
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6545604-9923
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License Number State | UT
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Taxonomy #6
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN014629
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License Number State | GA
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