Individual
AUSTIN JORDAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8950 US HIGHWAY 64 STE 108, LAKELAND, TN 38002-4566
(901) 308-5952
(901) 504-1522
Mailing address
8950 US HIGHWAY 64 STE 108, LAKELAND, TN 38002-4566
(901) 308-5952
(901) 504-1522
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10498
TN
122300000X
Dentist
6235
AL
1223G0001X
General Practice Dentistry
10498
TN
Other
Enumeration date
07/29/2015
Last updated
08/03/2022
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