Organization
GORDON B DAVIS MD DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON BRUCE DAVIS MD DDS (PRESIDENT)
(425) 348-1382
Entity
Organization
Contact information
Practice address
1111 PACIFIC AVE, SUITE A, EVERETT, WA 98201-4200
(425) 258-9586
(425) 259-1486
Mailing address
9810 MARINE VIEW DR, MUKILTEO, WA 98275-4110
(425) 348-1382
(425) 903-4402
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
WA
Other
Enumeration date
07/20/2010
Last updated
05/05/2016
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