# RANDY DAVIS DENTISTRY PA

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

## Provider details

- **NPI number:** 1578584447
- **Authorized official:** RANDY DAVIS DDS (PRESIDENT)
- **Authorized official phone:** (785) 539-0804

## Contact information

- **Practice address:** 1133 COLLEGE AVE, STE A103, MANHATTAN, KS 66502-2770
- **Practice address phone:** (785) 539-0804
- **Practice address fax:** (785) 587-9810
- **Mailing address:** 1133 COLLEGE AVE, STE A103, MANHATTAN, KS 66502-2770
- **Mailing address phone:** (785) 539-0804
- **Mailing address fax:** (785) 587-9810

## Taxonomy

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

## Other

- **Enumeration date:** 07/23/2006
- **Last updated:** 08/22/2020