Individual
JODY ANN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
220 E ROGERS RD, LONGMONT, CO 80501-6027
(303) 776-3250
(303) 682-9269
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10076
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47670231
—
CO
Enumeration date
03/29/2009
Last updated
11/08/2013
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