Organization
JEREMY B. DAVIDSON DDS PC
Active
Other names
Davidson Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY B DAVIDSON DDS PC (OWNER DOCTOR)
(504) 620-3400
Entity
Organization
Contact information
Practice address
401 N GREAT NECK RD, SUITE 122, VIRGINIA BEACH, VA 23454-4063
(504) 834-4392
Mailing address
401 N GREAT NECK RD, SUITE 122, VIRGINIA BEACH, VA 23454-4063
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401412449
VA
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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