MEDICARE: DR. KRISTA SCHOBERT DAVIS D.D.S.

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	122300000X	Dentist	0401410577	VA

General Provider Information

NPI Number	:	1417090242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTA SCHOBERT DAVIS D.D.S.

Provider Business Mailing Address
First Line	:	418 SOUTHRIDGE DR.
Second Line	:
City	:	RUCKERSVILLE
State	:	VA
Zip	:	22968
Country	:	US
Telephone Number	:	727-480-5527
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 N BERKSHIRE RD
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-2761
Country	:	US
Telephone Number	:	434-293-9916
Fax Number	:	434-293-3879

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2007

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