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General NPI Number Information
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NPI Number | 1891147914
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Entity Type | Individual
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Provider Name | DILLON ALEXANDER DAVIS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 1403 DUNN AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6346
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Country | US
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Telephone | 904-751-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 421 W CHURCH ST #522
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City | JACKSONVILLE
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State | FL
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Zip | 32202-4173
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Country | US
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Telephone | 870-918-9353
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22113
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License Number State | FL
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