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Individual

DR. AUSTIN THOMAS DAVIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
225 GUNDERSON DR, PORTAGE, WI 53901-3430
(608) 742-3272
Mailing address
W5566 GEMA DR, PARDEEVILLE, WI 53954-9795
(608) 617-5255

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001337
WI
1223G0001X
General Practice Dentistry
7961
NE

Other

Enumeration date
05/03/2023
Last updated
06/30/2024
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