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Individual

DR. JOHN BYRNSIDE DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
ROUTE 98 MEDWOOD PLAZA, SUITE 302, NUTTER FORT, WV 26301
(304) 622-5711
(304) 622-6001
Mailing address
ROUTE 98 MEDWOOD PLAZA, SUITE 302, NUTTER FORT, WV 26301
(304) 622-5711
(304) 622-6001

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019276
WV
122300000X
Dentist
3034
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7800056000
WV
Enumeration date
10/14/2006
Last updated
07/08/2007
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