Individual
KEITH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
3333 N MAYFAIR RD STE 311, WAUWATOSA, WI 53222-3219
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5000617
WI
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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