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Organization

RONNIE G. DAVIDSON II DMD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONNIE G. DAVIDSON II II DMD (PRESIDENT)
(704) 663-1800
Entity
Organization

Contact information

Practice address
134 N. MAGNOLIA ST., MOORESVILLE, NC 28115
(704) 663-1800
(704) 662-9569
Mailing address
134 N. MAGNOLIA ST., MOORESVILLE, NC 28115
(704) 663-1800
(704) 662-9569

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7363
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9024W
BCBS OF NC
NC
Enumeration date
10/29/2012
Last updated
10/29/2012
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