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Individual

DR. LAWRENCE HUEBERT DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3001 E CENTRAL AVE, WICHITA, KS 67214-4814
(316) 685-9791
(316) 685-6319
Mailing address
3001 E CENTRAL AVE, WICHITA, KS 67214-4814
(316) 685-9791
(316) 685-6319

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
014207
MO
1223G0001X
General Practice Dentistry
Primary
5808
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019212
BLUE CROSS BLUE SHIELD
KS
05
100222490B
KS
Enumeration date
09/26/2006
Last updated
07/08/2007
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