Organization
ROBERT B DAVIDSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BRUCE DAVIDSON D.D.S. (OWNER)
(630) 365-6127
Entity
Organization
Contact information
Practice address
708 N MAIN ST, ELBURN, IL 60119-9103
(630) 365-6127
(630) 365-6128
Mailing address
708 N MAIN ST, P.O. BOX 8031, ELBURN, IL 60119-9103
(630) 365-6127
(630) 365-6128
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.021402
IL
332BC3200X
Customized Equipment (DME)
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—
Other
Enumeration date
06/14/2014
Last updated
06/16/2014
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