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NPI Code Detail

MEDICARE: DANIELLE DAVIS

MEDICARE:   DANIELLE  DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6203AL
2122300000XDentist10530TN

General Provider Information

NPI Number : 1144602731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE DAVIS
Provider Business Mailing Address
First Line : 9775 HIGHWAY 64 STE 101
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-8587
Country : US
Telephone Number : 901-235-0709
Fax Number :
Provider Business Practice Location Address
First Line : 9775 HIGHWAY 64 STE 101
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-8587
Country : US
Telephone Number : 901-235-0709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2015
Last Update Date : 04/11/2018

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Directions to “ DANIELLE DAVIS ” Practice Location

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