MEDICARE: DR. GEORGE ARNOLD DAVIS JR. 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
1	1223G0001X	General Practice Dentistry	3205	NV

General Provider Information

NPI Number	:	1376765008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ARNOLD DAVIS JR. DDS

Provider Business Mailing Address
First Line	:	1930 VILLAGE CENTER CIR STE 12
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6238
Country	:	US
Telephone Number	:	702-562-2322
Fax Number	:	702-562-9610

Provider Business Practice Location Address
First Line	:	1930 VILLAGE CENTER CIR STE 12
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6238
Country	:	US
Telephone Number	:	702-562-2322
Fax Number	:	702-562-9610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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