# SAMUEL C DAVIDSON DDS LLC

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

## Provider details

- **NPI number:** 1841076288
- **Authorized official:** MRS. AILINA S DAVIDSON (OFFICE MANAGER)
- **Authorized official phone:** (307) 272-1688

## Contact information

- **Practice address:** 337 GREYBULL AVE, GREYBULL, WY 82426-2049
- **Practice address phone:** (307) 765-4654
- **Practice address fax:** (307) 333-0494
- **Mailing address:** 337 GREYBULL AVE, GREYBULL, WY 82426-2049
- **Mailing address phone:** (307) 765-4654
- **Mailing address fax:** (307) 333-0494

## Taxonomy

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

## Other

- **Enumeration date:** 09/01/2023
- **Last updated:** 09/01/2023