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General NPI Number Information
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NPI Number | 1952467805
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Entity Type | Organization
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Legal Business Name | DAVID B AVERY, DMD, PC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 3041 PEACH ORCHARD RD
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City | AUGUSTA
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State | GA
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Zip | 30906-3505
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Country | US
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Telephone | 706-798-6720
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Fax | 706-798-6130
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Provider Business Mailing Address
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Address Line | 3041 PEACH ORCHARD RD
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City | AUGUSTA
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State | GA
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Zip | 30906-3505
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Country | US
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Telephone | 706-798-6720
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Fax | 706-798-6130
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID B AVERY
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Credential | DMD
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Telephone | 706-798-6720
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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 | 9136
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License Number State | GA
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