Individual
PAUL DOUGLAS DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
213 N 5TH ST, PETERSBURG, IL 62675-1303
(217) 632-2077
Mailing address
213 N 5TH ST, PETERSBURG, IL 62675-1303
(217) 632-2077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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