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Individual

MR. ANDREW DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
200 W MAGNOLIA AVE, SUITE 120, FORT WORTH, TX 76104-7644
(817) 665-1323
(817) 871-9074
Mailing address
200 W MAGNOLIA AVE, SUITE 120, FORT WORTH, TX 76104-7644
(817) 665-1323
(817) 871-9074

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
0022258
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0022258
DDS LICENSE
TX
Enumeration date
07/10/2006
Last updated
07/08/2007
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