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NPI Code Detail

MEDICARE: DAVIS MICHELLE MCCALLISTER DDS

MEDICARE:   DAVIS MICHELLE MCCALLISTER  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 Dentistry2024020431MO
21223G0001XGeneral Practice Dentistry4755AR

General Provider Information

NPI Number : 1588407860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVIS MICHELLE MCCALLISTER DDS
Provider Business Mailing Address
First Line : 3 DARTEN CIR
Second Line :
City : BELLA VISTA
State : AR
Zip : 72714-2005
Country : US
Telephone Number : 573-356-3685
Fax Number :
Provider Business Practice Location Address
First Line : 3207 W ARAPAHO DR
Second Line :
City : ROGERS
State : AR
Zip : 72758-1363
Country : US
Telephone Number : 870-491-8138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2024
Last Update Date : 06/18/2024

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Directions to “ DAVIS MICHELLE MCCALLISTER DDS” Practice Location

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