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Organization

PHILIP DAVIS, DDS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARA BURROW (INSURANCE ADMIN)
(501) 940-1530
Entity
Organization

Contact information

Practice address
4100 W 28TH AVE, PINE BLUFF, AR 71603-4726
(870) 879-4870
Mailing address
4100 W 28TH AVE, PINE BLUFF, AR 71603-4726
(870) 879-4870

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
230610608
AR
Enumeration date
12/22/2020
Last updated
12/22/2020
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