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Organization
GARY DAVIS DDS INC
Active
Organization
GARY DAVIS DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY STEPHEN DAVIS DDS (CEO)
(949) 554-4844
Entity
Organization
Contact information
Practice address
27758 SANTA MARGARITA PKWY, SUITE334, MISSION VIEJO, CA 92691-6709
(949) 554-4844
Mailing address
27758 SANTA MARGARITA PKWY, SUITE334, MISSION VIEJO, CA 92691-6709
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
52166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134345937
PDA HOLDINGS LLC DBA MAGIC SMILES
AZ
05
—
232643
—
AZ
Enumeration date
02/19/2007
Last updated
07/16/2013
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