# JEFFREY S DAVIS DDS LTD

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

## Provider details

- **NPI number:** 1578200010
- **Authorized official:** MICHELLE JACOMINO (DIRECTOR OF PAYOR RELATIONS)
- **Authorized official phone:** (770) 916-9000

## Contact information

- **Practice address:** 2270 VALOR DR STE 105, WINCHESTER, VA 22601-6105
- **Practice address phone:** (540) 545-7878
- **Practice address fax:** (865) 675-4719
- **Mailing address:** 2270 VALOR DR STE 105, WINCHESTER, VA 22601-6105
- **Mailing address phone:** (540) 545-7878
- **Mailing address fax:** (865) 675-4719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2022
- **Last updated:** 05/17/2022