Organization
G. MICHAEL DAVIS DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. G MICHAEL DAVIS (OWNER)
(318) 649-6451
Entity
Organization
Contact information
Practice address
7915 HIGHWAY 165, COLUMBIA, LA 71418-3327
(318) 649-6451
Mailing address
7915 HIGHWAY 165, COLUMBIA, LA 71418-3327
(318) 649-6451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3388
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1833886
—
LA
Enumeration date
05/26/2016
Last updated
05/26/2016
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