Individual
DR. JOHN RANCE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
508 S 52ND ST, ROGERS, AR 72758-8600
(479) 845-1191
Mailing address
508 S 52ND ST, ROGERS, AR 72758-8600
(479) 845-1191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4911
AR
1223D0001X
Public Health Dentistry
2020022988
MO
1223G0001X
General Practice Dentistry
19572
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19572
STATE LICENSE
TX
01
—
2020022988
STATE LICENSE
MO
01
—
4911
DENTAL LICENSE
AR
01
—
752849726
TAX ID
—
Enumeration date
07/19/2006
Last updated
05/07/2026
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