Individual
DR. GLEN ANDREW DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
109 N ELM ST, WOODVILLE, OH 43469-1116
(419) 849-3771
(419) 849-3779
Mailing address
109 N ELM ST, P.O. BOX 141, WOODVILLE, OH 43469-1116
(419) 849-3771
(419) 849-3779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19382
OH
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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