Individual
DAN LEROY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
615 N MAIN, ELLINWOOD, KS 67526
(620) 564-2407
Mailing address
615 N MAIN, ELLINWOOD, KS 67526
(620) 564-2407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4918
KS
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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