Individual
KELLY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
741 CRYSTAL LN, STRASBURG, VA 22657-2373
(540) 664-6260
Mailing address
741 CRYSTAL LN, STRASBURG, VA 22657-2373
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402204011
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402204011
DENTAL HYGIENE LICENSE
VA
Enumeration date
07/31/2020
Last updated
07/31/2020
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