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Organization
GRANT DAVIS DENTAL ASSOCIATES PC
Active
Organization
GRANT DAVIS DENTAL ASSOCIATES PC
Active
Other names
Grant Davis Gribble Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVIS DDS (VICE PRESIDENT)
(505) 898-1976
Entity
Organization
Contact information
Practice address
3610 CALLE CUERVO NW, ALBUQUERQUE, NM 87114-8904
(505) 898-1976
(505) 792-0708
Mailing address
3610 CALLE CUERVO NW, ALBUQUERQUE, NM 87114-8904
(505) 898-1976
(505) 792-0708
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
05/23/2016
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