Organization
DAVIES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRSTEN M. DAVIES DDS (OWNER)
(262) 547-5813
Entity
Organization
Contact information
Practice address
2117 CORPORATE DRIVE, SUITE 100, WAUKESHA, WI 53189
(262) 547-5813
(262) 547-5835
Mailing address
2117 CORPORATE DRIVE, SUITE 100, WAUKESHA, WI 53189
(262) 547-5813
(262) 547-5835
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4907-015
WI
1223P0221X
Pediatric Dentistry
5000400-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33662900
—
WI
Enumeration date
09/29/2006
Last updated
07/05/2011
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