Organization
MICHAEL A. DAVIS, D.D.S. FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ANTONIA DAVIS D.D.S. (DOCTOR)
(317) 923-6964
Entity
Organization
Contact information
Practice address
3737 N. MERIDIAN STE. 410, INDIANAPOLIS, IN 46208
(317) 923-6964
(317) 923-4491
Mailing address
3737 N. MERIDIAN STE. 410, INDIANAPOLIS, IN 46208
(317) 923-6964
(317) 923-4491
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100120890A
—
IN
Enumeration date
03/30/2015
Last updated
03/30/2015
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