Individual
DR. BO M DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
8685 MARTIN WAY E STE 101, LACEY, WA 98516
(360) 489-1406
(360) 491-1270
Mailing address
8685 MARTIN WAY SE STE 101, LACEY, WA 98516
(360) 489-1406
(360) 491-1270
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE60112868
WA
Other
Enumeration date
04/11/2008
Last updated
07/03/2018
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