Individual
DR. MICHAEL WAYNE DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4100 HAWKINS ST NE, MIRA CONSULTING, ALBUQUERQUE, NM 87109-4548
(505) 898-2797
Mailing address
12315 TAMARAC TRL NE, ALBUQUERQUE, NM 87111-6210
(505) 294-0959
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2044
NM
Other
Enumeration date
10/18/2005
Last updated
07/08/2007
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