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Individual

DR. MICHAEL WILLIAM DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D. M. D.

Contact information

Practice address
133 CLEBOURNE ST, FORT MILL, SC 29715-1742
(803) 547-7508
(803) 547-1070
Mailing address
133 CLEBOURNE ST, FORT MILL, SC 29715-1742
(803) 547-7508
(803) 547-1070

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1880
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
408030
UNITED CONCORDIA
SC
05
ZA9804
SC
Enumeration date
10/17/2006
Last updated
07/08/2007
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