Individual
DR. JAMES WILLIAM DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2025 W ILES AVE, SUITE F, SPRINGFIELD, IL 62704-4190
(217) 787-6761
(217) 787-6611
Mailing address
2025 W ILES AVE, SUITE F, SPRINGFIELD, IL 62704-4190
(217) 787-6761
(217) 787-6611
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021.001294
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649342999
CORPORATE NPI
IL
Enumeration date
03/11/2010
Last updated
03/11/2010
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