Individual
DR. BRUCE K DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2350 SOUTH AVE, #104, LA CROSSE, WI 54601
(608) 788-7160
(608) 788-0173
Mailing address
PO BOX 187, LA CROSSE, WI 54602
(608) 788-7160
(608) 788-0173
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0002622
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33422700
—
WI
Enumeration date
11/14/2006
Last updated
07/08/2007
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