# MICHAEL E. DAVIS DMD, PC

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

## Provider details

- **NPI number:** 1679635023
- **Authorized official:** DR. MICHAEL EDWARD DAVIS DMD (PRESIDENT)
- **Authorized official phone:** (503) 248-1114

## Contact information

- **Practice address:** 2250 NW FLANDERS ST, SUITE 212, PORTLAND, OR 97210-3443
- **Practice address phone:** (503) 248-1114
- **Practice address fax:** (503) 248-1827
- **Mailing address:** 2250 NW FLANDERS ST, SUITE 212, PORTLAND, OR 97210-3443
- **Mailing address phone:** (503) 248-1114
- **Mailing address fax:** (503) 248-1827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 4512 | OR | Yes |

## Other

- **Enumeration date:** 12/14/2006
- **Last updated:** 08/22/2020