Individual
JEANNIE M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 2ND STREET, MONTPELIER, ND 58472-0001
(701) 251-3096
Mailing address
115 2ND STREET, MONTPELIER, ND 58472-0001
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
123456
WA
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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