Organization
DAVIS DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILLIAM DAVIS DMD (MANAGER)
(601) 825-2411
Entity
Organization
Contact information
Practice address
365 CROSSGATES BLVD, BRANDON, MS 39042-2602
(601) 825-2411
(601) 825-2419
Mailing address
365 CROSSGATES BLVD, BRANDON, MS 39042-2602
(601) 825-2411
(601) 825-2419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1828-79
MS
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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