Individual
DR. GRANT A DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1874 N HUNTERS RDG, SUITE 1, FAYETTEVILLE, AR 72701-2774
(479) 442-5092
(479) 587-0932
Mailing address
1874 N HUNTERS RDG, SUITE 1, FAYETTEVILLE, AR 72701-2774
(479) 442-5092
(479) 587-0932
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4060
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4060
LICENSE NUMBER
AR
Enumeration date
07/02/2015
Last updated
07/02/2015
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