| Organization Name: | DAVIES PEDIATRIC DENTISTRY |
| NPI Number: | 1003908856 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIRSTEN M. DAVIES (OWNER) |
| Mailing Address: | 2117 Corporate Drive Suite 100 Waukesha |
| State: | WI US |
| Postal Code: | 53189 |
| Phone Number: | 2625475813 |
| Fax Number: | 2625475835 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 07/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 5000400-015 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |