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Individual

DR. GLENN DAVIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3703 N KICKAPOO AVE, SHAWNEE, OK 74804-1703
(405) 275-0640
(405) 275-1502
Mailing address
3703 N KICKAPOO AVE, SHAWNEE, OK 74804-1703
(405) 275-0640
(405) 275-1502

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3839
OK

Other

Enumeration date
06/06/2006
Last updated
07/08/2007
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