Individual
SUSAN AILEEN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2212 S EASTERN AVE, LAS VEGAS, NV 89104-4124
(702) 735-9334
Mailing address
3325 RESEARCH WAY, CARSON CITY, NV 89706-7913
(775) 888-6610
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
101521
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101521
RDH LICENSE NUMBER
NV
Enumeration date
12/30/2019
Last updated
12/30/2019
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