Individual
DR. RANDALL L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 AMESBURY ST STE 203, LAWRENCE, MA 01840-1321
(978) 686-8500
(978) 686-4032
Mailing address
100 AMESBURY ST STE 203, LAWRENCE, MA 01840-1321
(978) 686-8500
(978) 686-4032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
16356
MA
1223G0001X
General Practice Dentistry
Primary
16356
MA
1223P0700X
Prosthodontics
16356
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280178
—
MA
Enumeration date
02/27/2007
Last updated
10/03/2016
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