Individual
PAUL FREDERIC DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
40217 NORTH SHORE DR., LOON LAKE, WA 99148-0765
(509) 233-9074
Mailing address
PO BOX 765, LOON LAKE, WA 99148-0765
(509) 233-9074
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00005119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5546205
—
WA
Enumeration date
12/05/2008
Last updated
12/05/2008
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