Individual
DR. JOHN CHARLES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3001A 6TH ST, GREAT LAKES, IL 60088
(847) 688-2755
(847) 688-2546
Mailing address
3001A 6TH ST, GREAT LAKES, IL 60088
(847) 688-2755
(847) 688-2546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
59937
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/10/2010
Last updated
05/29/2014
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