Individual
DR. DAVIS DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4110 W POINT LOMA BLVD, SAN DIEGO, CA 92110-5603
(619) 701-6622
Mailing address
11235 LEE WAY APT 15102, SAN DIEGO, CA 92126-3070
(626) 380-7626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101970
CA
126800000X
Dental Assistant
—
—
Other
Enumeration date
07/18/2011
Last updated
03/24/2023
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