Individual
ANDREA L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
11505 CINEMA DRIVE, SUITE 6, D'IBERVILLE, MS 39540
(228) 396-9000
(228) 396-9006
Mailing address
11505 CINEMA DRIVE, SUITE 6, D'IBERVILLE, MS 39540
(228) 396-9000
(228) 396-9006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3349-05
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01524745
—
MS
Enumeration date
01/05/2007
Last updated
03/12/2012
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