Organization
RANDALL L DAVIS DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL L DAVIS DMD (OWNER)
(978) 686-8500
Entity
Organization
Contact information
Practice address
100 AMESBURY ST, STE 203, LAWRENCE, MA 01840
(978) 686-8500
(978) 686-4032
Mailing address
100 AMESBURY ST, STE 203, LAWRENCE, MA 01840
(978) 686-8500
(978) 686-4032
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20413
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046143185
DELTA DENTAL
MA
01
—
30312396
MEDICAI
NH
05
—
9785914
—
MA
01
—
X11220
BC BS
MA
Enumeration date
02/27/2007
Last updated
03/09/2012
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