| Organization Name: | DAVIS DENTAL CENTERS, LLC |
| NPI Number: | 1114111747 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD CLAUDE DAVIS (OWNER-DENTIST) |
| Mailing Address: | 116 W Spotswood Ave Elkton |
| State: | VA US |
| Postal Code: | 228271119 |
| Phone Number: | 5402989419 |
| Fax Number: | 5402982774 |
| NPI Enumeration Date: | 08/27/2007 |
| NPI Last Update Date: | 08/27/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 0401008683 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |