Individual
BRANDON DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3455 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-4101
(478) 972-5773
Mailing address
121 OAKVIEW CLUB DR, MACON, GA 31216-4104
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123011
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/06/2022
Last updated
06/13/2023
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