Organization
DAVIS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN G. DAVIS D.D.S., M.S. (ORTHODONTIST)
(760) 781-1086
Entity
Organization
Contact information
Practice address
400 N BROADWAY, ESCONDIDO, CA 92025-2718
(760) 781-1086
(760) 781-1089
Mailing address
400 N BROADWAY, ESCONDIDO, CA 92025-2718
(760) 781-1086
(760) 781-1089
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
29576
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
973179
UNITED CONCORDIA
CA
01
—
B2957602
DENTICAL
CA
Enumeration date
08/14/2008
Last updated
04/05/2012
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