Individual
DR. WAYNE M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9733 USTICK RD, BOISE, ID 83704-5202
(208) 375-8720
Mailing address
9733 USTICK RD, BOISE, ID 83704-5202
(208) 375-8720
(208) 375-8734
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1320
ID
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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