Individual
CARLOS DAVILA PEIXOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20 KEYES DR APT 6, PEABODY, MA 01960-8024
(786) 499-9092
Mailing address
20 KEYES DR APT 6, PEABODY, MA 01960-8024
(786) 499-9092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DL13954
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
10/11/2012
Last updated
04/10/2019
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