# GINA R. DAVIS DDS PA

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

## Provider details

- **NPI number:** 1174679633
- **Authorized official:** DR. GINA RENEE DAVIS DDS (OWNER)
- **Authorized official phone:** (704) 547-8734

## Contact information

- **Practice address:** 10320 MALLARD CREEK RD, SUITE 160, CHARLOTTE, NC 28262-9756
- **Practice address phone:** (704) 547-8734
- **Practice address fax:** (704) 547-9605
- **Mailing address:** 10320 MALLARD CREEK RD, SUITE 160, CHARLOTTE, NC 28262-9756
- **Mailing address phone:** (704) 547-8734
- **Mailing address fax:** (704) 547-9605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6813 | NC | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 08/22/2020