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NPI Code Detail

MEDICARE: DR. GUY GEORGE DAVIS DDS

MEDICARE: DR. GUY GEORGE DAVIS DDS
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
11223G0001XGeneral Practice Dentistry23817CA

General Provider Information

NPI Number : 1265595029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GUY GEORGE DAVIS DDS
Provider Business Mailing Address
First Line : 2627 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95204-4429
Country : US
Telephone Number : 209-462-9300
Fax Number : 209-462-9313
Provider Business Practice Location Address
First Line : 2627 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95204-4429
Country : US
Telephone Number : 209-462-9300
Fax Number : 209-462-9313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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