Individual
MIRANDA ELIZABETH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2084 NE PROFESSIONAL CT, BEND, OR 97701-6077
(541) 383-3005
(541) 383-1883
Mailing address
PO BOX 4228, PORTLAND, OR 97208-4228
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11168
OR
1223G0001X
General Practice Dentistry
DE00010692
WA
Other
Enumeration date
11/20/2006
Last updated
07/25/2024
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