Individual
SCOTT ANDREW DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 916-3624
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8023839-9926
UT
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
8023839-9926
UT
Other
Enumeration date
08/13/2012
Last updated
08/22/2024
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