Organization
SPRINGFIELD PERIODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WILLIAM DAVIS D.M.D. (PERIODONTIST)
(217) 787-6761
Entity
Organization
Contact information
Practice address
2025 W ILES AVE, SPRINGFIELD, IL 62704-4190
(217) 787-6761
(217) 787-6611
Mailing address
2025 W ILES AVE, SPRINGFIELD, IL 62704-4190
(217) 787-6761
(217) 787-6611
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
11/14/2006
Last updated
08/22/2020
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