# MARK M. DAVIS, D.D.S., PC

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

## Provider details

- **NPI number:** 1457353278
- **Authorized official:** MARK M DAVIS D.D.S. (OWNER)
- **Authorized official phone:** (918) 742-8100

## Contact information

- **Practice address:** 5301 S LEWIS AVE, TULSA, OK 74105-6539
- **Practice address phone:** (918) 742-8100
- **Practice address fax:** (918) 858-1049
- **Mailing address:** 5301 S LEWIS AVE, TULSA, OK 74105-6539
- **Mailing address fax:** (918) 858-1049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | OK | Yes |

## Other

- **Enumeration date:** 08/11/2005
- **Last updated:** 07/21/2022