# GRIFFIN DAVIS PARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1427575307
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 33671 | TX | Yes |
| 122300000X | Dentist | 6943 | NV | — |

## Other

- **Enumeration date:** 08/23/2017
- **Last updated:** 05/06/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 33671 | TEXAS STATE BOARD | TX |