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Organization
MAVIS DENTAL
Active
Organization
MAVIS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVIS WAYNE GARDNER DDS (OWNER/DOCTOR)
(804) 396-1213
Entity
Organization
Contact information
Practice address
4805 LAKE BROOK DR STE 150, GLEN ALLEN, VA 23060-9278
(804) 396-1213
Mailing address
4805 LAKE BROOK DR STE 150, GLEN ALLEN, VA 23060-9278
(804) 396-1213
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/14/2026
Last updated
09/14/2026
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