Organization
GKLM, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT ALAN DAVIDSON DDS (DENTIST)
(479) 442-5092
Entity
Organization
Contact information
Practice address
1874 N HUNTERS RDG STE 1, FAYETTEVILLE, AR 72701-2896
(479) 442-5092
(479) 587-0932
Mailing address
1874 N HUNTERS RDG STE 1, FAYETTEVILLE, AR 72701-2896
(479) 442-5092
(479) 587-0932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2439
AR
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
08/04/2021
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