Individual
DR. TRACY DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2481 EXECUTIVE DR, EAST TROY, WI 53120
(262) 642-5695
Mailing address
PO BOX 642, EAST TROY, WI 53120
(262) 642-5695
(262) 642-5395
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5518
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33781300
—
WI
01
—
391449280018
BLUE CROSS
—
Enumeration date
03/02/2007
Last updated
07/08/2007
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