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General NPI Number Information
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NPI Number | 1790959856
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Entity Type | Organization
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Legal Business Name | DAVIS ORTHODONTICS
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 8509 N 51ST AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-4919
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Country | US
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Telephone | 623-931-8517
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Fax | 623-934-4846
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Provider Business Mailing Address
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Address Line | 8509 N 51ST AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-4919
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Country | US
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Telephone | 623-931-8517
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Fax | 623-934-4846
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. JAMES PAUL DAVIS
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Credential | DDS
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Telephone | 623-931-8517
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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 | 1882
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License Number State | AZ
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