Organization
PARTNERS IN DENTAL HEALTH II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEENAN M DAVIS DDS (PARTNER)
(757) 588-1563
Entity
Organization
Contact information
Practice address
738 E BAYVIEW BLVD, STE 3, NORFOLK, VA 23503-5447
(757) 588-1563
(757) 962-5318
Mailing address
738 E BAYVIEW BLVD, STE 3, NORFOLK, VA 23503-5447
(757) 588-1563
(757) 962-5318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005418
VA
1223G0001X
General Practice Dentistry
0401006401
VA
1223G0001X
General Practice Dentistry
0401411811
VA
1223P0700X
Prosthodontics
0401008797
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1975530
UCCI
VA
Enumeration date
09/12/2008
Last updated
09/12/2008
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