# GORDON B DAVIS MD DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073826996
- **Authorized official:** MR. GORDON BRUCE DAVIS MD DDS (PRESIDENT)
- **Authorized official phone:** (425) 348-1382

## Contact information

- **Practice address:** 1111 PACIFIC AVE, SUITE A, EVERETT, WA 98201-4200
- **Practice address phone:** (425) 258-9586
- **Practice address fax:** (425) 259-1486
- **Mailing address:** 9810 MARINE VIEW DR, MUKILTEO, WA 98275-4110
- **Mailing address phone:** (425) 348-1382
- **Mailing address fax:** (425) 903-4402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | WA | Yes |

## Other

- **Enumeration date:** 07/20/2010
- **Last updated:** 05/05/2016