MEDICARE: DR. CHRISTOPHER SCOTT DAVIS D.M,D

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	7274	KY
2	122300000X	Dentist	7274	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	610977734	OTHER	KY	DENTAL INS TAX ID

General Provider Information

NPI Number	:	1386702041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SCOTT DAVIS D.M,D

Provider Business Mailing Address
First Line	:	833 LANE ALLEN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3605
Country	:	US
Telephone Number	:	859-277-1189
Fax Number	:	859-276-2719

Provider Business Practice Location Address
First Line	:	833 LANE ALLEN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3605
Country	:	US
Telephone Number	:	859-277-1189
Fax Number	:	859-276-2719

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	01/13/2015

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